Posted 3/25/2009 10:41 PM (GMT -6)
High Gleason's (8-10) are high risk disease unless the tumor has escaped the prostate capsule. The reasoning is that they are more susceptable to recurrence or progression. Advanced Prostate Cancer is debated depending on where you read it. But it typically is cancer that has advanced beyond the prostate. Some institutions call it locally advanced if metastasis (mets) are not located in bones, angiolymphatic system, distant organs, or imaging scans.
For me it was called advanced because I had 4 positive margins, seminal vesivle invasion (SVI), and identified progression near the rectum. Yours could be called locally advanced or advanced in some institutions, but for the purpose of treating it, high risk locally advanced prostate cancer would likely be used.
Most institutions differ locally advanced PCa from metastatic, or progressive prostate cancer when deciding on treatment options. Metastatic prostate cancer requires systemic treatment as do many T3 patients...
For patients who had surgery:
pT2x = Local contained prostate cancer. T2c can have a focally positive border in the capsule but no extraprostatic extention (EPE) ~ Stage II
pT3a = Focally positive margin or EPE. ~ Stage III
pT3b = EPE, positive surgical margins, or SVI ~ Stage III
pT4a = Metastatic prostate cancer spread to one or more local lymph nodes ~ Stage IV
pT4b = Metastatic prostate cancer spread to bones, distant organs or lymph nodes. ~ Stage IV
I hope this helps...