Getting from there to here
Illustration by Jaelen Brock


To speak about the less invasive treatment options available for prostate cancer, we need to talk about how we got to this point.

By the time a man has been diagnosed with prostate cancer, he has likely undergone numerous tests, including but not limited to a digital rectal exam (DRE), multiple prostate-specific antigen (PSA) tests and at least one biopsy.

As we learned in the previous installment, the biopsy helps determine what's next because lab analysis of the cells harvested during a prostate biopsy gives your urologist a great deal of information. It helps them understand the details and type of cancer you have and helps shape the contours of the best path moving forward.

"If [the biopsy] shows cancer, there are basically different grade groups of prostate cancer," said Petar Bajic, M.D., a urologist specializing in men's health with the Cleveland Clinic. "One is the least aggressive, five is the most aggressive. Depending on that, and depending on the PSA and other factors, the guy would discuss with his urologist what the options might be for each individual case."

The grades of cancer are part of a system for understanding cancer known as Gleason scores, a tiered schematic developed in the 1960s by a pathologist who studied the patterns healthy cells take as they mutate into cancer cells. Grade 1 refers to basically normal cells, while grade 5 represents cells so mutated they hardly look like human cells at all.

The types of treatments discussed here are typically only offered to individuals with lower-risk types of prostate cancer.