Skip Navigation

How Aggressive is Your Prostate Cancer

  • Estimate Your Risk

  • Very Low Risk

  • Low Risk

  • Intermediate Risk

  • High Risk

  • Very High Risk

  • Metastatic

Calculate


PSA:

Gleason score:

Clinical stage/rectal exam:

Note:
Abnormal 1 : Does not extend beyond prostate
Abnormal 2 : With extension beyond the prostate

Imaging:


Very Low-Risk Prostate Cancer


  • PSA <10
  • Gleason 3+3=6 and fewer than two cores
  • Clinical exam: Normal

Management Options


  • Active surveillance
  • Open radical prostatectomy
  • Robotic radical prostatectomy
  • Radiation therapy

Clinical Trials


If you’d like to participate in a clinical trial at Johns Hopkins, visit the Institute for Clinical and Translational Research.

Low-Risk Prostate Cancer


  • PSA 0-10
  • Gleason 3+3=6 and more than two cores
  • Clinical exam: Normal or half abnormality, one side only

Management Options


These men have a very low risk of dying from prostate cancer and generally do well with most forms of therapy. This is the most common form of prostate cancer.

  • Active surveillance
  • Open radical prostatectomy
  • Robotic radical prostatectomy
  • Radiation therapy

Clinical Trials


If you’d like to participate in a clinical trial at Johns Hopkins, visit the Institute for Clinical and Translational Research.

Intermediate-Risk Prostate Cancer


  • PSA 10-20
  • Gleason 3+4 or 4+3
  • Clinical exam: Abnormality that does not extend beyond the boundary of the prostate

Management Options


  • Open radical prostatectomy
  • Robotic radical prostatectomy
  • Radiation therapy

Clinical Trials


If you’d like to participate in a clinical trial at Johns Hopkins, visit the Institute for Clinical and Translational Research.

High-Risk Prostate Cancer


  • PSA >20
  • Gleason 4+4 or 4+5, more than five cores
  • Clinical exam: Abnormality that extends beyond the prostate with no fixation

Management Options


These men have a much higher risk of recurrence with surgery or radiation or surveillance, and often benefit from more aggressive combination approaches.
  • Open radical prostatectomy
  • Robotic radical prostatectomy
  • Radiation therapy and two to three years of hormonal suppression

Clinical Trials


If you’d like to participate in a clinical trial at Johns Hopkins, visit the Institute for Clinical and Translational Research.

Very High-Risk Prostate Cancer

 

  • Gleason 5+4 or 4+5
  • Gleason 4+4 or 4+5 and more than four cores
  • Clinical exam

Management Options


  • Open radical prostatectomy
  • Robotic radical prostatectomy
  • Radiation therapy

Clinical Trials


If you’d like to participate in a clinical trial at Johns Hopkins, visit the Institute for Clinical and Translational Research.

Metastatic


  • PSA
  • Gleason
  • Clinical exam

Management Options


  • Hormone therapy
  • Chemotherapy
  • Radium 223
  • Immunotherapy

Clinical Trials


If you’d like to participate in a clinical trial at Johns Hopkins, visit the Institute for Clinical and Translational Research.

Resources


back to top button