Prostate Cancer

Question 1

Gleason Score and Grades

Answer 1

• Grade 1: 2-6
• Grade 2: 7 (3+4)
• Grade 3: 7 (4+3)
• Grade 4: 8 (4+4) or (3+5) or (5+3)
• Grade 5: 9-10
• 6 or below is low risk, 7 is intermediate risk, 8-10 is high risk

Question 2

Prostate Cancer Management

Answer 2

• Watchful waiting indicated by low grade and low life expectancy
• If longer life expectancy and still low grade, or higher grade, brachytherapy, external-beam radiotherapy or surgery may be indicated
• In high risk disease, radical surgery, both brachy- and radiotherapy, radiotherapy plus androgen deprivation, or brachytherapy, radiotherapy and deprivation
• If metastatic, androgen derivation and chemo
• Surgery and brachy good for those with no co-morbidities
• Radiotherapy good for those with comorbidity