Updated 24 June 2009
Prostate cancer exhibits a wide range of biologic behaviour in a heterogeneous patient population. In elderly patients with life expectancies less than ten years, small volume or microscopic cancers, low grade and low PSA, no treatment is necessary. However, it is important to diagnose cancers in men with longer life expectancies who have more aggressive disease and in whom radical therapy offers a curative potential. Such prognostic factors have been grouped according to a Canadian GU Radiation Oncology Consensus, published in Canadian Journal of Urology 2001, as follows:
- Low Risk: must have all of the following:
- PSA <=10 ng/mL
- Gleason <=6
- Stage T1/T2a
- Intermediate Risk: Neither low nor high risk, and therefore have any of:
- PSA >10 ng/mL
- Gleason =7
- Stage 2B
- High Risk: must have any of the following:
- PSA >20 ng/mL
- Gleason >=8
- Stage T3a or worse
A discussion about treatment decision-making may be found at the Canadian Family Physician web site.