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Gleason 9 and 10 prostate cancers represent, potentially, the most dangerous of the newly diagnosed, non-metastatic, forms of prostate cancer because they have the highest likelihood of distant spread. However, a significant portion of these men will still be able to achieve a cure or durable remission with the proper treatment. Even more good news is that the recently FDA-approved PSMA PET scan offers men markedly improved staging compared to what was available before, which means a patient is more likely to receive appropriate treatment upfront. Here, PCRI's Alex asks Medical Oncologist Mark Scholz, MD, all about Gleason 9 and 10 prostate cancer in 2023.
0:06 In Gleason 9 prostate cancer, what is the significance of the volume of cancer graded as Gleason 5 and the amount graded as Gleason 4?
2:41 What are the cure rates in men with Gleason 9 prostate cancer?
3:17 Is focal therapy an option for Gleason 9?
4:39 Does radical treatment make more sense for a Gleason 9 to have the best chance of achieving a cure?
5:16 If someone with localized Gleason 9 is considering focal treatment, should they also have hormone therapy since it is a high-risk cancer?
7:00 Which forms of radiation are most effective for Gleason 9?
7:56 The two types of brachytherapy are "permanent" and "temporary" seed implants. Is one any better than the other?
8:23 How common is Gleason 10?
8:58 What is the "standard" protocol for Gleason 9 and 10 prostate cancer?
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