title: When is prostate cancer really cancer?
abstract: Several investigators have challenged the idea that low-grade cancers are a cause for concern, suggesting that the term cancer should not be applied to these tumors. This article reviews the defining features of cancer, and the diagnostic and prognostic classification systems currently used for prostate cancer. Logical, morphologic, and molecular evidence is presented to show that low-grade prostate cancers are correctly classified as cancer. The authors suggest, however, that 6 out of 10 on an aggressiveness scale is inappropriate for indolent cancer, and that a proposed reinterpretation of Gleason grading categories is a more logical way to address overtreatment.
authors.affiliation: Department of Pathology and Molecular Medicine, Queen's Cancer Research Institute, Queen's University, 18 Stuart Street, Botterell 329, Kingston, Ontario K7L3N6, Canada.
authors.forename: David M
authors.initials: DM
authors.lastname: Berman
authors.affiliation: Departments of Pathology, Urology, and Oncology, The Johns Hopkins Medical Institutions, 401 North Broadway Street, Room 2242, Baltimore, MD 21231, USA. Electronic address: jepstein@jhmi.edu.
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Epstein
mesh_terms: D003937:Diagnosis, Differential; D018450:Disease Progression; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*
chemical_list: D017430:Prostate-Specific Antigen
keywords: Gleason grade; Low-grade cancer; PSA screening; Prostate cancer