How Serious Is My Prostate Cancer?
Perhaps the first questions that came to mind following your prostate cancer diagnosis were something like: How bad is it? What’s going to happen to me?
The tests you have had so far, and may have in the near future, will help you and your doctor understand your prognosis (likely course and outcome). This is called risk-stratification—determining your risk of recurrent, aggressive prostate cancer—and will help guide you to the appropriate treatment.
Almost all other cancers in the body use “stages” to describe the cancer, such as stage 1 breast cancer, or stage 3 colon cancer. This is not usually done in prostate cancer. Assigning a “Risk Group” has been the most common method to describe a patient’s prognosis.
| Your PSA level | How likely is it that your cancer has spread beyond the prostate? |
| The grade of your tumor (done via biopsy) | How aggressive is your cancer? |
| The T-stage of your tumor | For example, is the prostate cancer contained completely within the prostate? |
| The spread of the cancer | Based on imaging, has the cancer spread to lymph nodes (termed the “N-stage” for nodes) or bones or other organs (termed the “M-stage” for metastasis) |
| The extent of the cancer revealed by the biopsy | For example, in a typical prostate biopsy which includes at least 12 needle core samples, a cancer found in 9 of the 12 cores is more advanced than a cancer found in just 2 of the cores. |
Newer tests of your tumor’s genetic material and/or proteins (called “biomarker testing”) may help provide further assessment of the aggressiveness of your cancer beyond the grade of your cancer, PSA, and T-stage. If you have a strong family history of cancer and/or are diagnosed with aggressive prostate cancer, ask your doctor about genetic counseling and testing. This may have implications for your family members. Click on the tile below to learn more about biomarker testing.
If you have a strong family history of cancer and/or are diagnosed with aggressive prostate cancer, ask your doctor about genetic counseling and testing. The results of genetic testing may guide treatment planning for patients with metastatic prostate cancer, and may also have implications for your family members’ risk of cancer. Click on the tile below to learn more about genetic testing.
Patients diagnosed with high-risk or metastatic prostate cancer should also ask their doctor about another type of tumor biomarker testing to look for specific changes in the cancer cells’ genetic material (DNA). You may hear this called “somatic” or “genomic” testing. There can be changes in the cancer’s genetic material, such that there are differences from the genes you inherited from your parents that are present in all of your other body cells. The results of these tests can help guide treatment planning. They may also indicate that you may be eligible for certain clinical trials. Learn more about specific treatments for advanced prostate cancer.
Testing can be done on prostate tissue or on tissue from a site where the cancer has spread (e.g., bones, lymph nodes). In some cases, testing can be done on a blood sample to analyze tumor DNA that is present in the bloodstream.
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