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There are numerous prognostic factors that your radiation oncologist
will review with you. These include:
Stage-TNM Chart
The “stage” of a cancer is a measure of how large and where a cancer
is in the body.
Gleason Score
A Gleason Score is a measure of the aggressiveness of the tumor based
on a biopsy specimen, ranking it from 2 to 10 (with 2 the least and 10 the
most aggressive). Your radiation oncologist will explain the significance
of the findings on your biopsy.
PSA
In most individuals, the level of PSA or prostate-specific antigen can
offer useful prognostic information. PSA is a protein or carbohydrate
substance capable of stimulating an immune response and an indicator that
cancerous cells may be present.). PSA levels have been correlated with the
risk of cancer spreading beyond the prostate. This information can help you
and your radiation oncologist decide the most appropriate treatment option.
Partin Tables
The Partin Tables, based on a large, multi-institutional study, can help
estimate the chances the disease will stay confined to the prostate or spread
outside of the prostate (extra-capsular disease) and involve the seminal
vesicles or lymph nodes.
Perineural invasion
Using biopsy specimens, a pathologist determine whether the cancer cells
are also spreading to the prostate gland nerves. This is known as “perineural
invasion.” Some studies have shown that once cancer cells spread to the prostate,
they could travel through these nerves, increasing the chance that the cancer will
spread to other parts of the body. Your radiation oncologist will talk with you in
more detail about perineural invasion.
Extent of tumor within the prostate
Typically your urologist will take at least six biopsy samples, or “cores.” Studies
suggest that the more cores that test positive for cancer cells, the greater the risk
that the disease will spread beyond the prostate. Typically, four or more cores of
tissue that show involvement with cancer indicate an increased risk of extra-capsular
disease.
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