Prostate Cancer: What You Need to Know

Prostate Cancer Doctor Arlington, TxA cancer diagnosis is scary, no doubt about it. You’ve had your MRI, your biopsy results are in, and your head is probably spinning.

WHAT HAPPENS NOW?

First of all, know that we’ve got your back. Dr. Bevan-Thomas will sit down with you and discuss your specifics in detail. But for now, here’s what you need to know.

HOW CONCERNED SHOULD I BE?

With cancer, there is always reason for concern. But the good news is that not all prostate tumors require aggressive treatment. One in every nine men will be diagnosed with prostate cancer in their lifetime, but some are very slow-growing and take years to develop to a level that requires treatment.

What’s more, because of better screening and treatment options, survival rates are much better than they used to be. These days, 99% of men with prostate cancer survive at least five years after diagnosis. And many men are cured completely.

Your prognosis will depend on the grade and stage of your cancer and the treatment options you choose.

WHAT DO YOU MEAN BY "GRADE OR STAGE"?

Grading and staging can seem pretty complicated, but simply put, grading determines how aggressive your cancer is under the microscope, and staging is how far the cancer has spread in your body.

GRADING

To grade your cancer, a pathologist will look at your biopsy tissue under a microscope and assign the sample a number. This number is expressed as a Gleason grade, which measures how aggressive the cells look under the microscope. If the cells have the characteristics of cancer, they are assigned a grade of 3 through 5. The higher the grade, the more aggressive the cancer. However, because there is a high risk that there can be several different grades of cancer in that biopsy core, two grades are given and this will subsequently become the Gleason score for that biopsy. Confused yet? Keep reading...

The lowest score is (3+3), and the highest is (5+5). For example, a score of (3+5) means that there were two different grades of cancer in that specimen on that spot on the prostate. The first number on the score, i.e. (3+5), means that Gleason 3 was found, and Gleason 5 cancer was also found. But there were fewer Gleason 5 cells than Gleason 3 (thus it is placed second in the parentheses). Because a biopsy samples tissue from several locations on your prostate, you can have a (3+4) and a (4+3) on different specimens from the same biopsy.

These numbers add up to a total score. Gleason 3+5=8 means your Gleason score (combined Gleason grades) is 8. Your score will help to determine if you need further imaging studies, such as a bone scan. A bone scan will show if the cancer has spread beyond your pelvis. Dr. Bevan-Thomas also uses the prostate MRI routinely as this is the most helpful imaging study to evaluate whether the cancer has spread outside of the prostate or potentially into the local lymph nodes.

Gleason ScoreYour Gleason score also determines your risk category according to National Comprehensive Cancer Network (NCCN) guidelines.

  • A score of 6 is low-risk.
  • A score of 7 means intermediate-risk.
  • A score of 8, 9, or 10 is considered high-risk.

From here, Gleason scores have grade groups which differentiate the risk between the different numbers. So a Gleason score 7 (4+3) is in a higher-grade group than a Gleason 7 (3+4) because there are more higher-grade cells in the (4+3) sample, and those cells have a higher risk of growing faster and beyond the prostate.

STAGING

Staging is done by DRE and imaging studies to determine how far the cancer has spread in your body.

Cancer staging is expressed as a number from I through IV. Stage I is a small tumor that hasn’t spread beyond your prostate. Stage II and III tumors are larger and may or may not have spread to nearby organs. A stage IV tumor is one that has spread to lymph nodes, bone, or more distant parts of your body.

STAGING

As you can see, the staging process is a little more complicated than grading, but Dr. Bevan-Thomas will make sure you understand how both pertain to your situation. For now, keep in mind that the lower your cancer’s stage, the better your outcome is likely to be.

SO WHAT'S THE NEXT STEP?

When Dr. Bevan-Thomas has all of your grading, staging, and imaging results, he will use that information to determine his treatment recommendations. Together, you will decide the best treatment course for your situation. See treatment options below.

A FINAL WORD

Dr. Bevan-Thomas knows that a cancer diagnosis can be overwhelming. As a prostate specialist, he has the experience and the commitment to help you sort through the confusion and make the best decisions to preserve your health and quality of life.

Urologist Dr. Richard Bevan-Thomas of Urology Partners
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