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Predicting and Monitoring Advanced Prostate Cancer

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Predicting Aggressive Prostate Cancer continued...

The stages of prostate cancer refer to the cancer size and how far it has spread. The stages are:

  • Localized Prostate Cancer is stage T1a to stage T2C. At this stage, the tumor is confined to the prostate.
  • Regional Prostate Cancer, also known as local extension, is stage T3a, T3b or T4. The tumor has grown through the prostate capsule, either into the seminal vesicles (a pair of glands next to the prostate) or into nearby muscles and organs.
  • Metastatic Prostate Cancer is referred to as M1, or if lymph nodes are involved, it is referred to as N1. The tumor has spread to the pelvic lymph nodes or more distant parts of the body.

Attention to the general health of a patient as well as the patient's wishes are also an important part of treatment decisions. 

Monitoring Prostate Cancer

If you are diagnosed with prostate cancer, your doctor will monitor the disease periodically to see if it is spreading and how well treatments are working. PSA continues to be the primary marker of how the disease is progressing or responding to treatment. 

Several recent studies indicate that PSA doubling time -- the time it takes for a patient's PSA level to double -- predicts how aggressive the cancer is. The faster the PSA level doubles, the more aggressive the cancer. 

When prostate cancer spreads, it usually goes to the bones or lymph nodes. Imaging techniques are available to see whether the cancer has spread to the bones and, if so, to what extent. Imaging techniques currently used include:

  • Bone scans create images of bones on a computer screen or film. The patient is injected with a small amount of radioactive material that travels through the bloodstream. The computer screen detects radioactive material that has collected in abnormal areas of the bone.
  • CT scans make computerized X-ray images that produce cross-sectional images of the body. These detailed images can reveal disease or abnormalities in tissue and bone.

Future Predictors of Prostate Cancer

Researchers are seeking more accurate ways of diagnosing, monitoring, and treating prostate cancer. Many of the studies focus on genes and genetic abnormalities of a cancer. Scientists have found that the product of a certain gene appears more often in advanced prostate cancers than in early stage prostate cancers. Now the goal is to determine if the presence of this gene product means that a cancer is more aggressive. Knowing this information can help doctors decide which patients may benefit from immediate treatment, and of what type. This and other genetic research will pave the way for earlier, more accurate predictors of cancer growth.

WebMD Medical Reference

Reviewed by David T. Derrer, MD on May 23, 2014
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