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From the AJCC 7th edition [5] and UICC 7th edition. [6]Stage I disease is cancer that is found incidentally in a small part of the sample when prostate tissue is removed for other reasons, such as benign prostatic hyperplasia, and the cells closely resemble normal cells and the gland feels normal to the examining finger.
Despite reduced testosterone levels, metastatic prostate tumors eventually continue to grow – manifested by rising blood PSA levels, and metastases to nearby bones. [ 62 ] [ 63 ] This is the most advanced stage of the disease, called castration-resistant prostate cancer (CRPC).
Bone pain due to metastatic disease is treated with opioid pain relievers such as morphine and oxycodone. External beam radiation therapy directed at bone metastases may provide pain relief. Injections of certain radioisotopes, such as strontium-89, phosphorus-32, or samarium-153, also target bone metastases and may help relieve pain.
The Gleason grading system is used to help evaluate the prognosis of men with prostate cancer using samples from a prostate biopsy.Together with other parameters, it is incorporated into a strategy of prostate cancer staging which predicts prognosis and helps guide therapy.
The highest levels of acid phosphatase are found in metastasized prostate cancer. Diseases of the bone, such as Paget's disease or hyperparathyroidism, diseases of blood cells, such as sickle-cell disease or multiple myeloma or lysosomal storage diseases, such as Gaucher's disease, will show moderately increased levels.
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