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Predicting and Monitoring Advanced Prostate Cancer


Predicting Aggressive Prostate Cancer


Commonly used markers for prostate cancer include:

  • Prostate-specific antigen (PSA) levels. PSA is a substance produced by the prostate gland. It is normal to secrete small amounts of PSA into the bloodstream. Larger amounts of PSA in the bloodstream usually signal that the prostate gland is enlarged, infected, or malignant. PSA levels are determined by a simple blood test. The higher the number the more likely the patient is to have prostate cancer. PSA levels of less than 10 fall into the low risk category, 10-19 the intermediate risk category, and 20 or higher the high risk category.
  • PSA velocity. Several studies indicate that when PSA levels increase sharply in the months before surgery, the cancer is likely to be aggressive. A signifcant rise is 50% within 6 months
  • Gleason score. The Gleason score "grades" tumors on the basis of how abnormal, or normal they look when the tissue is examined under a microscope. The tumor is given a number from 1-5. The most abnormal area, and the least abnormal area are evaluated. These numbers are then added. The higher the number, the more aggressive the tumor and the more likely its spread. A grade of 6 or less  means that cancer cells look similar to normal prostate cells. Grade7  falls under the intermediate risk range. Grades 8 to 10 indicate that cells look least like normal prostate gland cells.


  • Regional Prostate Cancer, also known as local extensio is stage T3a, T3b or T4. The tumor has grown through the prostate capsule, either into the seminal vesicles (a pair of glands next to the prostate) or into nearby muscles and organs.
  • Metastatic Prostate Cancer is referred to as M1, or if lymph nodes are involved is is referred to as N1. The tumor has spread to the pelvic lymph nodes or more distant parts of the body.

Attention  to the general health of a patient as well as the patient's wishes is also an important part of the treatment decision making process. 

WebMD Medical Reference

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