2. Prostate Cancer
Most common cancer in men (28%
cancers in men)
Lifetime risk in 1 in 6 white men and 1 in
5 African American
Median Age at diagnosis is 67 (but 3%
in 40’s and 22% in 50’s)
3. Age Distribution of Men Diagnosed with
Prostate Cancer 2000-2010
39%
40%
35%
28%
30%
22%
25%
20%
15%
7%
10%
3%
5% 1%
0%
30 40 50 60 70 80 90
Age
5. The prostate
gland has a
capsule around
it, and cancers
arise close to the
capsule, the
cancer may
invade through
the capsule or
extend up into
the seminal
vesicles
32. Prostate Cancer Cure Rate After Radical
Prostatectomy Based on PSA Prior to
Surgery
33. Cure Rate with Surgery Based on PSA
and Gleason Score (GS)
34. PSA (prostate specific antigen) and
radiation results
Relapsed after
PSA Level
Radiation
0.1 to 4 4%
4 to 10 7%
10 to 20 22%
20 - 50 48%
over 50 67%
35. Note that the PSA levels slowly decline
after completing radiation
37. Understanding a Pathology
Report
1. Histology: adenocarcinoma
2. Number of cores involved/ total number of cores
3. Gleason score: 3 + 3
4. Perineural invasion
38. Prostate cancers are called ADENOCARCINOMA (which just means cancer from
glandular tissue). The more the cancer cell is similar to a normal prostate cells, the less
dangerous, so well differentiated (Gleason 2 – 5) are much better than intermediate
grade (Gleason 6 – 7) and much better than poorly differentiated (Gleason 8-10) cancer
cells
39. Prostate Cancer Cure Rate After Radical
Prostatectomy Based on Pathologic Grade
(i.e. how mutated the cancer cells appear)
40. Gleason Scoring System
From the biopsy, the pathologist grades
the appearance of the cells. From least
serious (slow growing or Grade 1) to
the fastest growing and most dangerous
or grade 5).
The first number is the most common
pattern seen from 1 to 5
41. Gleason Scoring System
The second number is the next most
common pattern seen. So a 4+3 is more
serious than 3+4 even though they both
are Gleason 7.
So the slowest is a score of 2 and the
fastest (most dangerous) is a score of
10.
43. The higher the Gleason Score, the
lower the cure rates after surgery
95
90 5 Year
85 Survival
80 10 Year
75 Survival
70
65
60
55
50
6 7 8
Gleason Score
44. The higher the Gleason Score, the
lower the cure rates after radiation
95 5 year cure rate radiation
radiation plus hormones
90
85
80
75
70
65
60
3+3 3+4 4+4 4+5 5+5
Gleason Score
45. www.aboutcancer.com
Most Common Cancers
* brain
* breast
* colon/rectum
* gynecologic
* head and neck (mouth, tongue, oral, etc.)
* lung
* metastatic
* prostate
* skin cancer
Other Specific Cancers
Radiation or Chemotherapy or Surgery
Support and Resources
All Other Cancer Topics and cancer calculators
Other Topics
Best Web Sites
51. Prostate Cancer Risk Groups
combine all 3 things, the stage, the
PSA level and the Gleason score,
system used by the NCCN
•Low risk: (T1c, T2a Gleason 6, PSA <10)
•Intermediate risk: (T2b, T2c, Gleason 7, PSA 10-20)
•High risk: (T3, Gleason 8-10 or PSA > 20)