Aggressive prostate cancer refers to prostate cancer that grows and spreads rapidly, posing a higher risk of progression and severity compared to typical slow-growing prostate cancers. It is characterized by certain clinical and pathological features:
- Gleason score: A Gleason score of 8 to 10 indicates aggressive cancer. This score is based on how abnormal the cancer cells look under a microscope, with higher scores signifying more aggressive tumors
- Prostate-specific antigen (PSA) levels: PSA is a protein produced by the prostate. Levels above 20 ng/mL may indicate high-risk aggressive prostate cancer, although some aggressive subtypes may show low PSA initially
- Cancer staging: Aggressive prostate cancer is often diagnosed at stage 3 or 4, meaning the cancer has spread outside the prostate gland to nearby tissues, lymph nodes, or distant organs (metastasis)
- Cellular characteristics: Aggressive prostate cancers may have different cellular makeup, sometimes resisting hormone therapy and spreading quickly. Anaplastic or neuroendocrine prostate cancers are examples of aggressive variants
Symptoms of aggressive prostate cancer may include difficulty urinating, blood in urine, pelvic or back pain, fatigue, and weight loss, though early stages might be asymptomatic
. Because of its rapid progression and potential resistance to hormone treatments, aggressive prostate cancer is often not curable but can be managed with a combination of treatments such as surgery, radiation, chemotherapy, immunotherapy, and hormone therapy to control spread and symptoms
. In summary, aggressive prostate cancer is a high-risk form of prostate cancer defined by high Gleason scores, elevated PSA, advanced stage, rapid growth, and potential treatment resistance, requiring prompt and often multi- modal treatment approaches
