Harvard Men's Health Watch

Treating prostate cancer, Part II: Determining its severity

"How bad is it, Doc?"

It's the question most men ask when they get over the shock of learning that their prostate biopsy found cancer. And the very same question is just as important for doctors as for patients. Before doctors can tell a man what therapeutic options are available to him, they must determine the severity of the cancer.

It's a crucial question, but it can be hard to answer, particularly for prostate cancer. That's because the disease is so variable, ranging from indolent tumors that are all but harmless to aggressive tumors that are life-threatening. At the extreme ends of the spectrum, predicting the behavior of prostate cancer is fairly accurate, but in the far-more-common middle, it's a bit dicey. Still, doctors are making progress, and more will follow from new research.

To evaluate the severity of prostate cancer, doctors consider three factors: the anatomic stage of the disease, its microscopic grade, and biologic evidence of its likely behavior.

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