Prostate Cancer

STAGING

Stage A prostate cancer is a disease which is identified only at the time of a transurethral resection (TURP). This type of surgery is typically done as the treatment for benign prostatic hypertrophy and involves scraping out an inner core of the prostate through the penis.

Stage B cancer of the prostate means that the disease is indicated based on either an elevated PSA blood test or a palpable nodule in the prostate.

Stage C disease means that the cancer extends through the capsule of the gland into the tissue immediately adjacent to the prostate. This can be identified either by digital examination or by x-ray or ultrasound picture.

Stage D cancer of the prostate has spread to other parts of the body such as lymph nodes or bone.

Two other factors beyond the A, B, C, D staging carry important prognostic information in prostate cancer. One of these is the PSA blood test; the other is the Gleason score.

PSA , or prostatic specific antigen, is a commonly performed blood test. The normal value for the PSA is 0-4 ng/ml. When the PSA is above 4 ng/ml a patient should be checked for prostate cancer. In patients who have prostate cancer diagnosed, the higher the PSA, the less optimistic the prognosis. Thus, patients with PSA values above 10 tend to respond less effectively to the forms of treatment.

The Gleason score is a subjective analysis of the biopsy specimen by the pathologist. Using a regular microscope, the pathologist grades the cancer based on how poorly differentiated the cells appear. Very poorly differentiated cancers (Gleason scores 8, 9 , or 10) tend to have a more aggressive pattern of spread. Conversely, patients with cancers with low Gleason scores ( 2, 3, or 4) tend to have the longest life expectancy.