What determines how aggressive my prostate cancer becomes?

Question

Hello doctor,

I am a 41-year-old male recently diagnosed with prostate cancer, and one thing confusing me is how differently doctors describe prostate cancer compared to other cancers. Some people live decades with slow-growing disease, while others progress rapidly.

My biopsy showed intermediate-risk disease, and now I am obsessively trying to understand what determines aggressiveness genetically or biologically. Why do some prostate cancers grow slowly and others fast at 41?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Please rest assured that nowadays prostate cancer is one of the cancers that is the easiest to treat and potentially cure, especially in the case of early detection. The earlier we diagnose it, the better the treatment outcomes. Because there are many effective treatment options available, we do not automatically become worried when someone is diagnosed with prostate cancer.

You may have heard that prostate cancer is often described as a slowly growing disease, and that depends on the biological behavior of the cancer cells themselves.

When we evaluate a patient with prostate cancer, we focus on two important factors:

The prostate-specific antigen PSA level.
The Gleason score.

In case both the level of prostate-specific antigen (PSA) and the Gleason score are low, we will probably suggest active monitoring instead of starting the treatment right away, since many men will be able to survive for many years without experiencing any problems from the presence of this tumor.

In case of an intermediate or high level of either prostate-specific antigen (PSA) or the Gleason score, we will have to decide on the most appropriate treatment regimen, which will consist of:

Surgery that might cause certain side effects affecting the quality of life.

Radiation that will make it possible to treat the tumor with utmost accuracy without damaging the surrounding tissues. Medication depends on a patient's health conditions.

As you can see, there are plenty of treatment methods available, and the most appropriate one always depends on a particular patient. The two most important parameters that should be considered are:

The level of prostate-specific antigen (PSA).
The Gleason score.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.