Difference between revisions of "Prostate cancer"

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===Management===
===Management===
====Dirty first approximation====
====Dirty first approximation====
*The management changes between [[Gleason score]] 6, 7 and 8.
*The management changes between [[Gleason score]] 6, 7 (3+4), 7 (4+3) and 8.


Typically, the implications are:
Typically, the implications are:
* Gleason 6: observation ''or'' radioactive seeds; surgery if patient wants.
* Gleason 6: observation ''or'' radioactive seeds; surgery if patient wants.
* Gleason 7: do something -- surgery ''or'' radiation therapy.
* Gleason 7 with a bit of Gleason pattern 4 and a low tumour volume: it is reasonable to watch ''or'' do something. ‡
* Gleason 7 with a lot of Gleason pattern 4 ''or'' a high tumour volume: do something -- surgery ''or'' radiation therapy.
* Gleason 8+: bad cancer -- do something quickly!
* Gleason 8+: bad cancer -- do something quickly!


Bottom line:  
Bottom line:  
*You want to be sure when you call something Gleason pattern 4.
*You want to be sure when you call something Gleason pattern 4.
Note:
* ‡ It has been said that ''Gleason score 7 with a bit of Gleason pattern 4 is the new Gleason score 6''.


====Observational strategies====
====Observational strategies====
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