NCCN Guidelines for Patients® | Prostate Cancer - page 21

NCCN Guidelines for Patients
: Prostate Cancer
Version 1.2014
Part 3: Treatment planning
Par t 1
Par t 2
Par t 3
Par t 4
Par t 5
Par t 6
Par t 7
Par t 8
Par t 9
• How the cancer will respond to treatment, and
• Whether the cancer will return (called a recurrence) if you’re cancer-free
after treatment.
However, this information often can only be known over time or after cancer
treatment has started. As such, your doctors will assess your chances (also called
risk) for such events. Risk groups and nomograms are two tools that doctors use.
Risk groups
Risk groups divide people with cancer into smaller subsets based on their
chances for an event. Some risk groups are based on one piece of information
while others use multiple pieces of information. In Part 5, treatment options are
presented by risk groups for prognosis. Risk is based on TNM scores, Gleason
score, and PSA values. NCCN experts recommend that these risk groups be
used as a foundation to start talking about treatment options.
A nomogram uses data from a large number of men and complex math to predict
risk. It can predict one person’s risk better than a risk group. A nomogram predicts
an event by taking into account similarities and differences among pieces of
information. In this booklet, test and treatment recommendations are sometimes
based on nomograms that predict how likely the cancer has spread to your lymph
nodes. Also, NCCN experts recommend that nomograms be used in addition
to recurrence risk groups to better plan treatment. Websites with information on
nomograms are listed in Part 3.4.
Gleason score:
grading system for prostate
cancer based on how well
the prostate cells can form
into glands
A prediction of
the pattern and outcome of
a disease based on clinical
A protein made by
the prostate
definitions of TNM
= Prostate-specific
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