0
October 3, 2007, Vol 298, No. 13 >
JAMA Patient Page | October 3, 2007

Grading of Prostate Cancer FREE

John L. Zeller, MD, PhD; Cassio Lynm, MA; Richard M. Glass, MD
JAMA. 2007;298(13):1596. doi:10.1001/jama.298.13.1596.
Text Size: A A A
Published online
Article
Figures
Figures in this Article

Prostate cancer (an abnormal, uncontrolled growth of cells originating in the prostate gland) is the most common cancer among American men. The October 3, 2007, issue of JAMA includes an article on the importance of grading prostate cancer and the implications regarding therapy options and possible recurrence.

Grahic Jump LocationImage not available.

DIAGNOSTIC TESTING FOR PROSTATE CANCER

Doctors and medical groups do not agree on when men should be screened (routinely tested) for prostate cancer because of controversy about the benefits versus risks of early treatment. The most often used tests include

  • Digital rectal examination (DRE). A doctor feels the prostate gland by passing a gloved finger into the patient's rectum to examine the gland for hard or lumpy areas that may represent an abnormality.

  • Prostate-specific antigen (PSA) test. A blood test is performed to measure levels of this chemical substance. A positive test result (usually considered to be more than 4 nanograms per milliliter) may be an indicator of cancer but it is important to understand that the test is not perfect. Many men with mildly elevated PSA levels can have benign prostate enlargement, which is a normal part of aging; whereas some men with prostate cancer may have normal levels of PSA.

  • Biopsy (obtaining tissue samples) of the prostate. To do a biopsy, your doctor inserts an ultrasound probe into the rectum. Guided by images from the probe, the physician can identify suspicious areas of the prostate gland. Using a fine hollow needle, he or she can remove thin sections of glandular tissue for microscopic analysis.

GRADING OF PROSTATE CANCER

When a biopsy confirms the presence of cancer, the next step, called grading, is to determine how aggressive the cancer is. The most common cancer grading scale runs from 1 to 5, with 1 being the least aggressive form (tissue cells look normal). Known as the Gleason scores, these numbers (which refer to the appearance and activity of cancer cells) may be helpful in determining which treatment option is best. The Gleason score adds the grades of the 2 most prevalent patterns of cells. Therefore, scores may range from 2 (nonaggressive cancer) to 10 (very aggressive cancer). The eventual spread of the tumor is dependent on the aggressive nature of the prostate cancer cells.

TREATMENT OPTIONS

Decisions regarding treatment depend on a number of factors, including age, life expectancy, overall health status, PSA level, Gleason score, and the growth and spread of the tumor. Treatment options should be carefully discussed with your doctor and range from watchful waiting for signs and symptoms with regular checkups to radiation treatment or surgery. Radical prostatectomy (surgical removal of the prostate gland) and radiation treatment can cure prostate cancer but can result in problems regarding impotency (difficulty having an erection) or incontinence (problem with control of urination).

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on prostate cancer was published in the November 15, 2006, issue of JAMA.

Sources: American Cancer Society, American Association of Clinical Urologists

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.

TOPIC: CANCER

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Letters

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
A personalized automated messaging system to improve adherence to prostate cancer screening: research protocol.
JMIR research protocols ;
Can diffusion-weighted magnetic resonance imaging predict a high Gleason score of prostate cancer?
Korean journal of urology ;
© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems