A recent study out of Johns Hopkins shows that a new and simple grading system may be effective for predicting outcomes in men with prostate cancer. In fact, the researchers say the test — in an analysis of 20,000 men — appears to be an improvement over the Gleason grading system, the current standard. A report describing the study will appear in an upcoming issue of the journal European Urology.
According to data from the American Cancer Society, more than 230,000 men were diagnosed with prostate cancer n 2014 and almost 30,000 died from the disease. “The new system should make treatment options clearer to physicians and patients,” Jonathan I. Epstein, MD, a professor of pathology, oncology and urology at the Johns Hopkins University School of Medicine and a member of the Johns Hopkins Kimmel Cancer Center, said in a news release.
The Gleason system has 25 possible scores, while the new system has only five, offering a significant enough improvement to the Gleason system that the World Health Organization and the International Society of Urological Pathology have already accepted it for use.
Using the new system, 50% of the 20,000 of the men in the study received more appropriate treatment than they would have had the Gleason score been used to assess the likelihood of their cancer’s growth and spread, according to the upcoming report.
The new assessment method also may be more appropriate for today’s patients. “The prostate cancer that we see today is not the same that we used to see four decades ago,” Dr. Epstein noted, “because diagnoses and treatments have evolved and prognoses have improved.” Using the new system, more benign tumors that have not grown further than the prostate can be more readily recognized, and are classified as “Group 1.” Correctly identifying these slow-growing tumors is important, since for these patients radical prostatectomy or radiotherapy are not necessary treatment options.
“An older man with Grade Group 1 cancer will mainly need active surveillance of the tumor and probably won’t require radiotherapy or surgery, which sometimes have significant side effects, such as impotence or incontinence,” Dr. Epstein said. Younger man with this type of tumor will need to be monitored, since they have the potential to grow into more aggressive cancer as a man ages. “This new system will benefit patients globally,” he concluded.