Prostate Cancer: One Man's Story

The most common cancer
The cancer Doug was diagnosed with (see "You have prostate cancer" in this feature) is the most common cancer in Canada. 1 in 7 men will be diagnosed with it over their lifetime. In 2011, about 25,500 men were diagnosed with prostate cancer and about 4,100 men died of it.

Prostate cancer is uncontrolled growth of the cells of the prostate gland. The prostate plays an important role in sexual functioning, urination, and reproduction. In prostate cancer, the cells within the walls of the prostate begin to multiply and eventually leave the prostate gland, spreading to invade the body parts close to the prostate - the lymph nodes and bladder - or elsewhere, particularly to the spine. About 30% of men diagnosed with prostate cancer end up dying of it. Men have about the same chance of dying of prostate cancer as women have of dying of breast cancer.

The Gleason score
When a biopsy shows that a man has prostate cancer, the pathologist will apply a "Gleason score" to it. The Gleason score is an important number, as it defines how aggressively the tumour is growing and will reflect the treatment options available. The lower the score, the better a patient's chance of survival. When Doug's cancer was biopsied, it was assigned a Gleason score of 7 - a score of 8 or higher is considered "very aggressive."

The stages of prostate cancer
Prostate cancer is also "staged" - assigned a stage based on the tumour's characteristics, such as its size and whether there is evidence that it has spread. Staging also helps determine the prognosis and treatment options.

• In Stage T1, the cancer tumour is microscopic and actually can't be detected by a DRE. A biopsy is needed to find traces of the tumour.
• In Stage T2, the tumour has grown but is still confined to the prostate itself and can be removed by taking out the whole prostate. The doctor can detect it at this stage by DRE.
• By Stage T3 or T4, the cancer is deadlier because it has spread outside the prostate gland to the seminal vesicles (which produce semen) or to the bladder (where urine is stored).