Understanding Your Pathology Report: Prostate Cancer
When your prostate was biopsied, the samples taken were studied under the microscope by a specialized doctor with many years of training called a pathologist. The pathologist sends your doctor a report that gives a diagnosis for each sample taken. Information in this report will be used to help manage your care. The questions and answers that follow are meant to help you understand medical language you might find in the pathology report from your prostate biopsy.
> > > 1 Bedtime Hack To Pee Like A Bull
An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.
Survival Of Prostate Cancer
Survival depends on many factors. No one can tell you exactly how long you will live.
Below are general statistics based on large groups of people. Remember, they cant tell you what will happen in your individual case.
Survival for prostate cancer is generally good, particularly if you are diagnosed early.
Read Also: What Are The Screening Tests For Prostate Cancer
Further Treatment When Margins Are Positive
For men who decide to pursue observation, PSA monitoring should be performed with ultrasensitive technology. Then, if the PSA rises, treatment can be initiated at a very early stage, when the PSA is still less than 0.1. Cure rates are best when treatment is started at a lower level of PSA.
When surgical margins are positive, several studies show that immediate radiation to the prostate fossa will lower relapse rates and may slightly improve 10-year survival rates. However, since only 50% of men will relapse, waiting for evidence of a PSA rise before starting radiation may be a reasonable alternative. Generally, the monitoring process consists of checking PSA every 3 months. Radiation is initiated if the PSA rises above 0.2.
Radiation is the most common treatment for management of a local relapse after surgery. While radiation is often effective, the possibility of microscopic metastases outside the prostate fossa in another area of the body needs to be considered. Radiation to the fossa alone will not be curative if the disease has spread. Unfortunately, a final determination about the presence or absence of microscopic metastasis can never certain. No current technology consistently detects microscopic disease with 100% accuracy.
Diagnosed In March 2020 Prostate Cancer
I just found this group tonoght My husband is 65 He is diagnosed with prostate cancer that has spread to his bones and pelvis as well His PSA is 23 He had biopsy in April along with bone scan and MRI He had a pain pump unplanted 2 weeks ago to control pain as Oxycotin was not helping He recently had a 3 injections at cancer center I do not have the names with me but I know after a month he is going to start Fermagon?? He started taking chemo pills last Thursday Aeateda?? I will get correct names and post again later As you can tell I am VERY new and do not know what questions I should be asking His next appoint ment is May 7 Please let me know what I should be asking His Gleason is 9 Please I need all the advice I can get to help my husband live a normal life as possible Thank you
You May Like: Is Asparagus Good For Prostate Cancer
Recommended Reading: Prostate Cancer Spread To Skull Prognosis
The Ajcc Tnm Staging System
A staging system is a standard way for the cancer care team to describe how far a cancer has spread. The most widely used staging system for prostate cancer is the AJCC TNM system, which was most recently updated in 2018.
The TNM system for prostate cancer is based on 5 key pieces of information:
- The extent of the main tumor *
- Whether the cancer has spread to nearby lymph nodes
- Whether the cancer has spread to other parts of the body
- The PSA level at the time of diagnosis
- The Grade Group , which is a measure of how likely the cancer is to grow and spread quickly. This is determined by the results of the prostate biopsy .
*There are 2 types of T categories for prostate cancer:
- The clinical T category is your doctors best estimate of the extent of your disease, based on the results of the physical exam and prostate biopsy, and any imaging tests you have had.
- If you have surgery to remove your prostate, your doctors can also determine the pathologic T category . The pathologic T is likely to be more accurate than the clinical T, as it is done after all of your prostate has been examined in the lab.
Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once the T, N, and M categories have been determined, this information is combined in a process called stage grouping to get the overall stage of the cancer.
Gleason Score For Grading Prostate Cancer
Prostate cancer is also given a grade called a Gleason score. This score is based on how much the cancer looks like healthy tissue when viewed under a microscope. Less aggressive tumors generally look more like healthy tissue. Tumors that are more aggressive are likely to grow and spread to other parts of the body. They look less like healthy tissue.
The Gleason scoring system is the most common prostate cancer grading system used. The pathologist looks at how the cancer cells are arranged in the prostate and assigns a score on a scale of 3 to 5 from 2 different locations. Cancer cells that look similar to healthy cells receive a low score. Cancer cells that look less like healthy cells or look more aggressive receive a higher score. To assign the numbers, the pathologist determines the main pattern of cell growth, which is the area where the cancer is most obvious, and then looks for another area of growth. The doctor then gives each area a score from 3 to 5. The scores are added together to come up with an overall score between 6 and 10.
Gleason scores of 5 or lower are not used. The lowest Gleason score is 6, which is a low-grade cancer. A Gleason score of 7 is a medium-grade cancer, and a score of 8, 9, or 10 is a high-grade cancer. A lower-grade cancer grows more slowly and is less likely to spread than a high-grade cancer.
Recommended Reading: Symptoms Of Severe Prostate Cancer
Prognostic Nomogram For Os
To establish a prognostic nomogram in predicting OS for prostate cancer patients with Gleason score 7, the study population were randomly divided into the training group and testing group in a 7:3 ratio. The nomogram integrating all the significant independent factors for OS based on the training cohort is shown in Figure 6A. The C-index for nomogram of OS prediction was 0.785 , and 0.788 in the training and validation cohort, respectively. The calibration plots indicated an optimal agreement between the actual observation and nomogram prediction for OS probability at 5 and 10 year in the training cohort and testing cohort .
Figure 6. Nomogram for OS of Gleason score 7 prostate cancer Nomogram for CSS of Gleason score 7 prostate cancer.
Clinical Outcomes For Patients With Gleason Score 910 Prostate Adenocarcinoma Treated With Radiotherapy Or Radical Prostatectomy: A Multi
- Amar U. KishanCorrespondenceCorresponding author. Department of Radiation Oncology, Suite B265, 200 Medical Plaza, Los Angeles, CA 90095, USA. Tel. +1 825 9771 Fax: +1 825 7194.
- Department of Radiation Oncology, University of California, Los Angeles, CA, USADepartment of Radiation Oncology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Urology, University of California, Los Angeles, CA, USADepartment of Urology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
Also Check: What Is The Best Over The Counter Prostate Medicine
Effect On Survival Of Local Treatment In Patients With Low Prostate
Shuai Liu1#, Xiao-Ying Wang2#, Tian-Bao Huang3, Quan Niu4, Kai Yao3, Xing Song1, Shi-Yao Zhou1, Zhen Chen1, Guang-Chen Zhou3
1Department of Graduate School, Department of Urology, Subei Peoples Hospital of Jiangsu Province , China
Contributions: Conception and design: S Liu Administrative support: GC Zhou Provision of study materials or patients: S Liu Collection and assembly of data: S Liu, XY Wang, TB Huang, K Yao Data analysis and interpretation: S Liu, XY Wang, Q Niu, X Song, SY Zhou, Z Chen Manuscript writing: All authors Final approval of manuscript: All authors.
#These authors contributed equally to this work.
Correspondence to:
Background: Emerging data suggest that in patients with low prostate-specific antigen and high Gleason score, prostate cancer is more aggressive and more likely to be related to genomic characteristics of neuroendocrinology. However, the evidence for the advantages of local treatment for these men is lacking. Hence, we investigated survival in men with low-PSA values and high-grade PCa according to the treatment of the primary tumor.
In patients with low PSA values, Gleason score 810, and localized PCa, LT resulted in higher survival compared with NLT. Within LT, RP provided the most benefit relative to RT.
Keywords: Prostate cancer radical prostatectomy radiotherapy non-local treatment prostate-specific antigen propensity score matching
Submitted Oct 23, 2019. Accepted for publication Apr 07, 2020.
doi: 10.21037/apm-19-414
Very Scared: Gleason 9 Prostate Cancer
Hi all
I saw my specialist last week and he informed me that I had level 9 Gleason prostate cancer. I am awaiting a CT scan and then a bone scan. I am in no pain whatsoever at the moment and I consider myself quite fit playing golf 4 times a week and walking with my wife and dog the other days. I am 60 years old and am quite scared for my future. I am not scared of the pain, just not being around for my wife and 2 grown up children.
Can anyone give me hope for optimism as all I have seen about level 9 gleason is not great.
You May Like: Prostate Specific Antigen Psa Test Meaning
Also Check: Gleason Score 7 Prostate Cancer Treatment Options
What Does It Mean To Have A Gleason Score Of 6 7 8 Or 9
Because grades 1 and 2 are not often used for biopsies, the lowest Gleason score of a cancer found on a prostate biopsy is 6. These cancers may be called well differentiated or low-grade and are likely to be less aggressive that is, they tend to grow and spread slowly.
Cancers with Gleason scores of 8 to 10 may be called poorly differentiated or high-grade. These cancers are likely to grow and spread more quickly, although a cancer with a Gleason score of 9-10 is twice as likely to grow and spread quickly as a cancer with a Gleason score of 8.
Cancers with a Gleason score of 7 can either be Gleason score 3+4=7 or Gleason score 4+3=7:
- Gleason score 3+4=7 tumors still have a good prognosis , although not as good as a Gleason score 6 tumor.
- A Gleason score 4+3=7 tumor is more likely to grow and spread than a 3+4=7 tumor, yet not as likely as a Gleason score 8 tumor.
What You Need To Know About The Prostate What Is A Pt3a Prostate Cancer
The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This is why the prostate is important to the body. It can be caused by many factors, including infection and inflammation.
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.
You May Like: Benign Prostatic Hypertrophy With Outflow Obstruction
Whats The Best Way To Treat Localized Gleason 9
EBRT plus brachytherapy and ADT appeared to afford the best outcomes.
The most aggressive localized prostate cancer has a Gleason score of 9-10. Whats the best way to treat it? Radiation oncologist Phuoc Tran, M.D., Ph.D., and colleagues recently took part in a multi-institutional study to find out. Their results were published in the Journal of the American Medical Association .
Investigators at 12 hospitals in the United States and Norway compared the clinical outcomes of 1,809 men with Gleason score 9-10 prostate cancer after they had either radical prostatectomy, external-beam radiation therapy with androgen deprivation therapy , or EBRT plus a brachytherapy boost with ADT the men were treated between 2000 and 2013. Of these men, 639 underwent radical prostatectomy, 734 had EBRT and ADT, and 436 had EBRT plus brachytherapy, along with ADT.
We found that treatment with either EBRT and ADT or radical prostatectomy appeared to be equivalent but EBRT plus brachytherapy and ADT appeared to afford the best outcomes of the three.
This work was published with Hopkins co-investigators Ashley Ross, Jeff Tosoian, Stephen Greco, Curtiland DeVille, Todd McNutt, Daniel Y. Song, and Theodore L. DeWeese.
Donât Miss: Best Diet To Fight Prostate Cancer
The Initial Causes What Is A Pt3a Prostate Cancer
One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.
Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.
If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.
You May Like: Prostate Cancer Deaths Per Year
Figure : Zones Of The Prostate
To help your doctor more precisely determine the location of prostate cancer or another condition, such as high-grade PIN, your pathology report may name specific areas. For example, it may refer to the apex, located at the bottom of the prostate the base, at the top or the mid zone, the area between the apex and base. Alternatively, it may note three zones: the peripheral zone , the central zone , and the transition zone . Seventy percent of prostate cancers arise in the peripheral zone. Few arise in the anterior prostate.
Stage 1 Prostate Cancer Treatment
Where stage 1 prostate cancer patients are of an advanced age, a watch and wait approach* is usually chosen over conventional medical treatment. This is because tumors can be slow growing at this early first stage and the survival rate is very high. For example, a person over 80 years old who is diagnosed with stage 1 prostate cancer could be more likely to die from other causes. Treatment could mean the benefits are outweighed by negative side effects. *also referred to as watchful waiting
However, in cases where a younger person has been diagnosed with first stage prostate cancer, there may be more immediacy in treating the disease rather than monitoring it. A younger person will have more years ahead of them in which the cancer can develop, and they may also make a better recovery following medical treatment.
When treatment is given, the treatment options are similar to those for stage 2 prostate cancer. The prostate gland may be removed through a procedure known as a radical prostatectomy. Radiation therapy and hormonal therapy may also be administered to shrink any tumors.
You May Like: How Do Prostate Cancer Patients Die
Has Your Cancer Spread Beyond The Prostate
Prostate Cancer Stage is the rating system consisting of four stages used to describe the spread of cancer. The different stages of cancer describe cancer confined within the prostate, growth that extends to tissue outside the prostate, to local organs or metastasized to distant parts of the body. Several different tests can be used either alone or in combination to determine the extent of spread of the cancer. Not all of these tests are needed in all men. Staging tests include the DRE, PSA Blood Test, Ultrasound, Biopsy, Bone Scan, Cat Scan, MRI and PET Scan.
Prostate Cancer Stage is the rating system consisting of four stages used to describe the spread of cancer. The different stages of cancer describe cancer confined within the prostate, growth that extends to tissue outside the prostate, to local organs or metastasized to distant parts of the body. Several different tests can be used either alone or in combination to determine the extent of spread of the cancer. Not all of these tests are needed in all men. Staging tests include the DRE, PSA Blood Test, Ultrasound, Biopsy, Bone Scan, Cat Scan, MRI and PET Scan.