What is prostate cancer risk classification?

1. Low-risk prostate cancer: Stage T1-T2a and Gleason score ≤6 and PSA ≤10
2. Intermediate-risk prostate cancer: Stage T2b and/or Gleason score =7 and/or 10< PSA ≤20
3. High-risk prostate cancer: Stage ≥T2c or Gleason score 8–10 or PSA >20

What are PSA and the Gleason score?

PSA (prostate-specific antigen) is a protein produced by prostate cells. Measuring its blood level is used in prostate cancer diagnosis and follow-up after treatment. The normal PSA value is below 4.

Gleason score is a scoring system that gives an idea of cancer cells’ rates of multiplication and spread and assesses how different cancer cells are from normal cells. The Gleason score ranges from 2-10, and a higher score means the cancer is more aggressive and progresses faster.

T staging is staging according to tumor dimensions:

• Stage T1 - T2a: The tumor is in less than half of one side of the prostate
• Stage T2b: The tumor is in more than half of one side of the prostate
• Stage T2c: The tumor is in both lobes of the prostate
• Stage T3 and above: The tumor has extended beyond the prostate capsule

Both the diagnosis and treatment of prostate cancer differ from other cancers; this cancer is both hormone-sensitive and usually slow-growing. Patients with this condition or suspected prostate cancer should not rush, especially into starting treatment; first, they should make a plan with their medical oncologists to determine cancer stage and their risk group. Establishing the patient’s risk group through a very accurate and meticulous radiological and pathological assessment is the most important determinant of the treatment decision.

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