The Prostate Cancer Risk Calculators
Risk Calculator 1 the general health calculator is a starting point, looking at family history, age and any medical problems with urination.
Risk Calculator 2 the PSA risk calculator looks at the levels of prostate specific antigen in patients blood to help predict whether further investigation is required.
Risk calculator 3 and 4 the urologist risk calculator using data from DRE, TRUS and/or MRI and providing probabilities based on traditional Gleason grading or with inclusion of cribriform growth for the definition of clinically significant prostate cancer.
The option of calculating probabilities based on a definition of clinically significant prostate cancer including information on cribriform growth and intraductal carcinoma is currently available for the risk calculators without MRI information.
See table below for difference in definition of clinically significant prostate cancer
| Indolent prostate cancer | ||
|---|---|---|
| Gleason score 3+3 | Gleason 3+4 of higher or clinical stage > T2B | |
| Cribriform risk calculator 3/4 | GG1 or GG2 without cribriform growth or intraductal carcinoma | GG2 with cribriform or intra ductal carcinoma or GG3 or higher |
Nowadays these risk calculators are combined into one decision tree and thus can be used for men that have not been previously biopsied but also for men that have been screened previously and had a prostate biopsy with a benign result. In addition, if available, there is an option to include the result of an MRI .
How We Treat Prostate Cancer
The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.
About Dr Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
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Survival For All Stages Of Prostate Cancer
Generally for men with prostate cancer in England:
- more than 95 out of 100 will survive their cancer for 1 year or more
- more than 85 out of 100 will survive their cancer for 5 years or more
- almost 80 out of 100 will survive their cancer for 10 years or more
Survival of prostate cancer is also reported in Scotland and Northern Ireland. But it is difficult to compare survival between these countries because of differences in the way the information is collected.
Cancer survival by stage at diagnosis for England, 2019Office for National Statistics
These statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account the background mortality that they would have experienced if they had not had cancer.
Development And Validation Of A Life Expectancy Calculator For Us Patients With Prostate Cancer
Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
Correspondence: Elizabeth C. Chase, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
Correspondence: Elizabeth C. Chase, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
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Metastatic Prostate Cancer Prognosis Calculator
Impact of obesity upon prostate cancer-associated mortality: A meta-analysis of 17 cohort studies.Smoking as a risk factor for prostate cancer: a meta-analysis of 24 prospective cohort studies.20-year outcomes following conservative management of clinically localized prostate cancerContribution of obesity to international differences in life expectancy
The metastatic prostate cancer prognosis calculator assesses life expectancy and mortality risk connected to prostate cancer diagnosis in men.
Please, remember – all the calculations are only estimations and are based on the general population statistics. Math cannot predict the future – every single case, history and disease is different and unrepeatable.
Follow the article below to find out more about prostate cancer, its risk factors, and overall survival. We will also talk about the risk assessment process used in our prostate survival calculator.
Risk Of Progression Of Prostate Cancer
Prostate cancer can also be classified based on the risk of recurrence . For this assessment, that can impact your choice of therapeutic approach, we take into account your clinical stage, PSA level, and Gleason score.
Low risk
Your cancer may be at low risk of spreading if:
- Your PSA level is less than 10 ng/mL
- You Gleason score is 6 or less
- Your cancer is stage T1 or T2a
Medium risk
Your cancer may be at medium risk of spreading if:
- Your PSA level is between 10 and 20 ng/mL
- Your Gleason score is 7
- Your cancer is stage T2b
High risk
Your cancer may be at high risk of spreading if:
- Your PSA level is higher than 20 ng/mL
- Your Gleason score is 8, 9 or 10
- Your cancer is stage T2c, T3 or T4
Recommended Reading: Johns Hopkins Prostate Cancer Second Opinion
Psa Doubling Time Calculator
INSTRUCTIONS
Use in patients with prostate cancer. Do not use for screening or diagnosis.
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Patients with prostate cancer who have undergone radical prostatectomy or definitive radiation therapy and have biochemical recurrence, defined as confirmed PSA 0.2 ng/mL if radical prostatectomy or confirmed PSA rise of 2 ng/mL above the nadir PSA level if radiation therapy.
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PSADT has limited value in prostate cancer screening or diagnosis.
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For patients with biochemical recurrence of prostate cancer, optimal PSADT calculation should include all PSA values of the individual within two years of initially documented PSA recurrence.
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Entering more values improves accuracy of estimation.
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Shorter PSADT reflects faster increase in PSA levels, while longer PSADT reflects a slower increase in PSA levels over time.
Prostate Cancer Survival Trends Over Time
As with most cancers, survival for prostate cancer is improving. However, interpretation of prostate cancer survival trends is difficult as the case-mix on which they are based is likely to have changed over time with earlier diagnoses following the advent of TURP and PSA testing. The detection of a greater proportion of latent, earlier, slow-growing tumours in more recent time periods will have the effect of raising survival rates due to lead-time bias . Lead-time bias for prostate cancer is estimated to be between five and 12 years, varying with a man’s age at screening. Data from the European Randomized Study of Prostate Cancer estimates that for a single screening test, mean lead times are 12 years at age 55 and six years at age 75. Some of the increase may also be attributed to genuine improvements in survival due to more effective treatment, for both early, aggressive prostate cancers and advanced cases.
One-year age-standardised net survival for prostate cancer has increased from 66% during 1971-1972 to 94% during 2010-2011 in England and Wales an absolute survival difference of 28 percentage points.
Prostate Cancer , Age-Standardised One-Year Net Survival, Men , England and Wales, 1971-2011
Prostate Cancer , Age-Standardised Five-Year Net Survival, Men , England and Wales, 1971-2011
Prostate Cancer , Age-Standardised Ten-Year Net Survival, Men , England and Wales, 1971-2011
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Survival By Disease Progression
The extent prostate cancer has progressed can influence survival rates.
Prostate-specific antigen is a protein produced by cells of the prostate gland by normal and malignant cells. In men with prostate cancer, blood levels of PSA are often elevated.
Doctors can use PSA as a marker to better understand the progression of prostate cancer and the resulting prognosis.
One way doctors assess the progression of the disease is through PSA doubling time. This refers to the number of months it takes for PSA to double.
One study suggests a short doubling time means a poorer prognosis for patients with stage IV prostate cancer. Median survival was 16.5 months for those with a PSA doubling time lower than 45 days compared with 26 months for patients with a longer PSA doubling time.
Whether or not the cancer has metastasized and spread to other areas of the body outside the prostate can also influence survival. In distant or stage IV prostate cancer, when cancer has spread from the prostate to other organs like the liver or lungs, the five-year survival rate is 31% compared with localized cancer, which has a five-year survival rate of nearly 100%.
Survival By Tumor Grade
One way cancer is staged is by looking at the grade of cancer. Grade refers to how cancer cells look like under a microscope.
Traditionally for prostate cancer, this has been done using the Gleason Score, which was developed in the 1960s. Under this system, cancerous cells are categorized on a scale from 1 to 5. Grade 1 cells are considered normal prostate tissues, while cells in the grade 5 range have mutated to such an extent they no longer resemble normal cells.
In determining a Gleason score, a pathologist will examine a biopsy sample under a microscope and give a Gleason grade using the above scale to the most predominant pattern displayed, then a second grade to the pattern that is the second most predominant. Those two grades are then added to form the overall Gleason score .
In theory, Gleason scores could range from 2 to 10, but pathologists today rarely give a score between 2 and 5 and are more likely to be in the range of 6 to 10 with 6 being the lowest grade of prostate cancer.
Under the Gleason Score system, a 6 is considered low grade, 7 is intermediate and scores of 8, 9, or 10 are considered high-grade cancers.
The higher the Gleason score, the more likely it is the prostate cancer will grow and spread quickly.
However, there have been some issues with the Gleason system, and a new grading system, to act as an extension of the Gleason system, has been developed.
Under this system Gleason scores are now categorized into grade groups:
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Prostate Cancer Survival By Age
Five-year survival for prostate cancer shows an unusual pattern with age: survival gradually increases from 91% in men aged 15-49 and peaks at 94% in 60-69 year olds survival falls thereafter, reaching its lowest point of 66% in 80-99 year olds patients diagnosed with prostate cancer in England during 2009-2013. The higher survival in men in their sixties is likely to be associated with higher rates of PSA testing in this age group.
Prostate Cancer , Five-Year Net Survival by Age, Men, England, 2009-2013
Good Prostate Cancer Care
Your MDT will be able to recommend what they feel are the best treatment options, but ultimately the decision is yours.
You should be able to talk with a named specialist nurse about treatment options and possible side effects to help you make a decision.
You should also be told about any clinical trials you may be eligible for.
If you have side effects from treatment, you should be referred to specialist services to help stop or ease these side effects.
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What Is The Gleason Score For Prostate Cancer Calculator
This is a health tool helping with the staging of prostate cancer based on biopsy findings. The Gleason grading system is a scale describing the aggressiveness of prostate cancer and refers to the microscopic examination of the sample tissue in the prostate biopsy.
It is a comparison of the pattern in the cancerous tissue with normal tissue in terms of shape, disposition and spread.
There are two grades assigned to the two predominant cancer cell patterns and first it is assessed the most commonly observed type of cell then the second most common type. This Gleason score for prostate cancer calculator uses the standard staging criteria in the model as follows.
Stages Of Prostate Cancer
In order to determine the stage of a patients prostate cancer, most doctors start by using the TNM staging system, which helps describe different aspects of the cancers growth.
- T the T category measures the size and extent of the Tumor
- N the N category measures whether and how far the cancer has spread to the Lymph Nodes
- M the M category whether the cancer has spread to other organs in the body (a process called Metastasis
The score for each of these categories is determined based on a pre-determined set of criteria. Your doctor cannot feel or see the tumor with a score of T1. A score of T3 means that the tumor has begun to grow outside of the prostate.
After calculating the TNM categories, doctors will combine the TNM score with the patients Gleason score and PSA levels assigning of a specific stage to the patients cancer.
Prostate cancer prognosis and survival rates can help give patients an idea of their chances of surviving the disease based on the stage and time of diagnosis. While some patients may find this information helpful, others may not want to know.
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Why Is Life Expectancy Important In Pca Treatment Decisions
The NCCN recommendation to take life expectancy into account underscores the value of matching the treatment not just to your prostate cancer, but to your age and general health as well. An aggressive treatment like radical prostatectomy reduces the likelihood of developing PCa metastasis, which is an incurable killer, but increases the chances of urinary and sexual side effects, so many patients feel like its a toss-up between quantity vs. quality of life. On the other hand, patients with slow-growing disease who have co-existing medical conditions such as cardiovascular disease or stroke history are more likely to die from non-cancer causes such patients may not be candidates or wish to go through a major surgery why put quality of life on the line during the years they have remaining? They may therefore decide on a less aggressive approach like Active Surveillance.
Risk Factors For Prostate Cancer
Factors that can increase your risk of prostate cancer include the following.
- Older age: Your risk of prostate cancer increases as you age.
- Race: Black men have a greater risk of prostate cancer than do men of other races. In black men, prostate cancer is also more likely to be aggressive or advanced. Its not clear why this is.
- Family history of prostate or breast cancer: If men in your family have had prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer or a very strong family history of breast cancer, your risk of prostate cancer may be higher.
- Obesity: Obese men diagnosed with prostate cancer may be more likely to have advanced disease thats more difficult to treat.
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Prostate Cancer And Its Risk Factors
Prostate cancer is a malignant growth of a walnut-shape male organ called the prostate.
Prostate cancer is currently the 2nd most common neoplasm worldwide – the disease is diagnosed in over 1,200,000 men every year. The statistic says that 1 in 9 American males will develop prostate cancer at some point in their lives.
We also have some good news – more than 98% of prostate cancer patients will survive at least 10 years.
Prostate cancer risk factors:
- Family history of prostate/breast/ovarian cancer, especially at a young age
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The tumor has spread to other organs, or lymph nodes |
Please find information below |
As we can see, the survival and life expectancy of a patient with stages T1-T3 are not that different from the general population. Majority of prostate cancer patients will die of another reason than the neoplasm itself.
Stage 4 prostate cancer life expectancy depends on the presence of metastases – fragments of cancer that have spread to other organs of the body, outside of the pelvis.
Metastatic prostate cancer life expectancy.
- Cancer with metastases is automatically a Stage 4 cancer.
- In this case, stage four prostate cancer survival rate equals 31% – it means that only 1/3 of patients with metastases will survive another five years.
Stage 1 Prostate Cancer
In stage 1, the cancer is confined to the prostate. Stage 1 prostate cancer cant be detected during a digital rectal exam and is usually expected to be slow-growing. The tumor is one half of one lobe of the prostate or even less . There is no regional lymph node metastasis and no distant metastasis. . The PSA level is below 10ng/ml. The Grade Group is 1.
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Prognostic Grouping Of Prostate Cancer
TNM prognostic grouping for prostate cancer is based on the stage, PSA level and Gleason score. This grouping is more accurate in predicting a prognosis than TNM staging alone. It goes without saying that the lower the scores, the best outlook and chance that your cancer can be successfully treated without the cancer coming back .
In contrast, if the prognosis is darker for men with higher scores, there may still be treatment options to control your cancer, improve your quality of life and prolong your survival.
Doctors also use nomograms to predict a prostate cancer prognosis. Nomograms are predictive tools.
What Affects Survival
Your outlook depends on the stage of the cancer when it was diagnosed. This means how big it is and whether it has spread.
The type of prostate cancer and grade of the cancer also affects your survival. Grade means how abnormal the cells look under the microscope. The most common system used to grade prostate cancer is the Gleason score. Men with a higher Gleason score have a poorer outlook.
Your outlook also depends on your PSA level. A high PSA level may mean your cancer grows more quickly.
Your general health and fitness also affect survival. The fitter you are, the better you are able to cope with your cancer and treatment.
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