Types of Prostate Cancer
Prostate cancer refers to an uncontrollable accumulation of cells in the prostate gland. When the cancer occurs it means the ability to control the multiplication, growth and death of prostate cells has been lost. The prostate cells form abnormal cells that join into masses known as tumors. Once formed, a tumor can remain at its original location and not spread to any location outside the prostate. Such a tumor is called a primary tumor. But some spread to other areas of the body outside the prostate and are called secondary tumors.
Prostate Cancer Is Generally Slow-Growing
Most prostate cancers are relatively slow-growing. This means that a prostate tumor typically takes many years to grow and reach a size that is detectable. Likewise, it usually takes even a longer time for prostate cancer to spread beyond the prostate. Nevertheless, in a small percentage of men, prostate cancer can grow rapidly and spread aggressively to other areas. Because of this, it is quite difficult to know with certainty which prostate cancers are likely to grow slowly and which ones are likely to grow aggressively. It can be quite difficult to make the right treatment decisions.
Aggressive Versus Indolent Prostate Cancer
While there are many types of prostate cancers, urologists usually break them down into aggressive and indolent categories to make it easier to determine the right treatment and to treat various types of cancers effectively. Aggressive cancer is a high-risk prostate tumor that if not treated remains highly active and very likely to spread to areas outside the prostate gland. The cancer grows quickly, spreads early, rapidly and widely, and causes increased damage in the body. Because aggressive cancer spreads as secondary deposits and can quickly result in widespread damage, it progresses rapidly to advanced stage cancer and can be very difficult to treat. So for aggressive prostate cancers to be treated successfully, they should be diagnosed early and treatment should be started when the tumors are still in their early stages.
On the other hand, indolent prostate cancer is a low-risk, slow-growing and low-volume tumor that can sit in the prostate gland for many years without causing any problems. An indolent cancer is not likely to spread outside the prostate even if not treated. But if it does, the spread will be local and slow. In fact, patients with indolent prostate cancers can live for 10-20 years without the cancer causing any serious effects on their lives.
Identifying Aggressive Prostate Cancer
When a patient is diagnosed with prostate cancer, the urologist will take a biopsy of the prostate gland to make sure the cells are checked under the microscope to determine whether the cancer is aggressive or indolent.
Various cancer cells are examined and their activity graded using the Gleason score. When the microscopic exam returns a Gleason score greater than 7 for cancer that has not spread beyond the prostate, the cancer is classified as aggressive and the patient is given the appropriate treatment. However, if the Gleason score is 7 or below, the prostate cancer may be classified as indolent, depending on other patient factors.
The Gleason score also helps the urologist to decide the appropriate treatment. For instance, if it is an early-stage, slow-growing cancer with a score of 6 or below, the urologist may recommend active surveillance, which means that treatment is postponed and the patient is closely monitored for progress, such as whether the tumor is spreading or worsening. But to determine whether active surveillance is ideal, the urologist also will have to consider factors such as the patient’s life expectancy, overall health and concomitant illnesses. For aggressive cancer, the urologist will work with other doctors to create a treatment plan.
At Advanced Urology Institute in Florida we have a knowledgeable and experienced team of urologists to help diagnose and treat all types of prostate cancers. Our multidisciplinary approach to treatment ensures that even the most aggressive forms of cancer are treated safely and effectively. For more information on the screening, diagnosis, treatment, care and support for prostate cancer, visit the “Advanced Urology Institute” site.