So Your Prostate Biopsy Showed Cancer, What's Next?
11/30/1999
From the desk of
Jackson L. Gates, M.D.
Medical Director
Biopsy:
A biopsy of your prostate has been done by your urologist because of an abnormal PSA or digital rectal examination. Several areas of your prostate gland were sampled during the biopsy, submitted as needle cores of prostate tissue, and sent to our laboratory. A board-certified pathologist examined the biopsy cores under the microscope, and determined that there were cancerous cells present. Prognosis:
Prognostic factors in prostate cancer can be clinically complicated for several reasons, and requires that someone like you who has recently been diagnosed with prostate cancer, carefully consult with your clinical physician or urologist for adequate and appropriate treatment strategy and recommendations. Early detection of prostate cancer is important if a treatment can be found to arrest the development of the cancer. Recent international consensus conferences have listed certain prognostic factors as being practical and extremely useful based on scientific justifications. These would include, serum PSA levels, TNM (a staging system to assess how advanced a tumor is), histological grading (the standard recommendation is to use Gleason system of grading). The Gleason grading system consists of a total score of the two main patterns identified in your cancer specimen. The most common pattern is listed first, followed by the second most common pattern, or the highest grade. This is reported for example: Gleason score 7 = 4+3. Surgical margins are also an important in determining prognostic factors. Additional prognostic factors as listed by others include: age of patient, volume of tumor, extra capsular extension of tumor, seminal vesicle invasion, zone of origin of tumor, neuroendocrine differentiation, nuclear grading, tumor angiogenesis and oncogenesis (chromosome alterations), etc. Treatment Options:
You along with your physician will need to make a decision as to what kind of treatment is best. There are various treatment options available depending on the type of prostate cancer you have, and how far advanced the tumor is. You have to make the ultimate choice on which type of treatment would be best for you. There are various support and educational networks available to give you empowerment on making the best decision for you. Such resources include the American Cancer Society, the National Cancer Institute, etc. Nationwide patient.s with prostate cancer network groups are also available and can be provided to you through your physician urologist. Reference:
1. A. Buhmeida, et.al. Prognostic factors in prostate cancer. Diagnostic Pathology 2006, 1:4.
2. R.Montironi. Prognostic factors in prostate cancer: pathologists glean a wealth of clinical detail from the smallest of tissue-editorial. British Medical Journal, Feb.17, 2001.
Jackson L. Gates, M.D.
Medical Director
Biopsy:
A biopsy of your prostate has been done by your urologist because of an abnormal PSA or digital rectal examination. Several areas of your prostate gland were sampled during the biopsy, submitted as needle cores of prostate tissue, and sent to our laboratory. A board-certified pathologist examined the biopsy cores under the microscope, and determined that there were cancerous cells present. Prognosis:
Prognostic factors in prostate cancer can be clinically complicated for several reasons, and requires that someone like you who has recently been diagnosed with prostate cancer, carefully consult with your clinical physician or urologist for adequate and appropriate treatment strategy and recommendations. Early detection of prostate cancer is important if a treatment can be found to arrest the development of the cancer. Recent international consensus conferences have listed certain prognostic factors as being practical and extremely useful based on scientific justifications. These would include, serum PSA levels, TNM (a staging system to assess how advanced a tumor is), histological grading (the standard recommendation is to use Gleason system of grading). The Gleason grading system consists of a total score of the two main patterns identified in your cancer specimen. The most common pattern is listed first, followed by the second most common pattern, or the highest grade. This is reported for example: Gleason score 7 = 4+3. Surgical margins are also an important in determining prognostic factors. Additional prognostic factors as listed by others include: age of patient, volume of tumor, extra capsular extension of tumor, seminal vesicle invasion, zone of origin of tumor, neuroendocrine differentiation, nuclear grading, tumor angiogenesis and oncogenesis (chromosome alterations), etc. Treatment Options:
You along with your physician will need to make a decision as to what kind of treatment is best. There are various treatment options available depending on the type of prostate cancer you have, and how far advanced the tumor is. You have to make the ultimate choice on which type of treatment would be best for you. There are various support and educational networks available to give you empowerment on making the best decision for you. Such resources include the American Cancer Society, the National Cancer Institute, etc. Nationwide patient.s with prostate cancer network groups are also available and can be provided to you through your physician urologist. Reference:
1. A. Buhmeida, et.al. Prognostic factors in prostate cancer. Diagnostic Pathology 2006, 1:4.
2. R.Montironi. Prognostic factors in prostate cancer: pathologists glean a wealth of clinical detail from the smallest of tissue-editorial. British Medical Journal, Feb.17, 2001.