Prostate cancer treatment decisions
Prostate cancers tend to be slow-growing, but some can be more aggressive. Oncologists look at a variety of factors in order to decide whether to treat and, if treatment is recommended, what type of treatment will most benefit their patient. Important factors include:
- Patient’s age: For younger patients, there are many factors to consider in making treatment decisions such general health and the likelihood that the cancer is a more aggressive form of the disease. A younger patient may be more willing to accept possible side effects of treatment if they offer the best chance for cure. Older patients with less aggressive cancers might have less to gain from, and may forego treatment to avoid unwanted side effects.
- Stage of the cancer (i.e. whether or not the cancer has spread beyond the prostate gland, and if so, how much and to where)/
- Gleason score (2 to 10, with 10 being the highest) which is a measure of how different cancer cells look from normal cells. Doctors use this score to predict how quickly and aggressively prostate cancer will likely grow and to determine best treatment options.
- PSA levels in the blood: Prostate specific antigen (PSA) is a protein produced by both normal and cancerous prostate cells. An increase in PSA levels can indicate a number of non-cancerous conditions such as inflammation or an enlarged prostate gland, as well as prostate cancer. Sometimes doctors will follow the PSA over months or years to see if there is a pattern, which help determine the cause of the increased PSA and/or whether or not to do further studies or tests.
- Mutation status: Some clinical trials are studying PARP inhibitors or other agents to treat patients with advanced hereditary prostate cancer.
- Tumor test results: Tests performed on tumor tissue can predict how prostate cancers are likely to behave and how likely they are to recur after treatment.