Table of Contents Table of Contents
Previous Page  57 / 112 Next Page
Show Menu
Previous Page 57 / 112 Next Page
Page Background


NCCN Guidelines for Patients


Prostate Cancer, Version 1.2016


Treatment guide: Initial treatment

Intermediate risk

Surgical treatment

If you are expected to live 10 or more years, a

radical prostatectomy is a second option. Your pelvic

lymph nodes may also be removed if your risk for

them having cancer is 2% or higher. Your doctor will

determine your risk using a nomogram, which was

described in Part 3.

The tissue that will be removed from your body during

the operation will be sent to a pathologist. He or she

will assess how far the cancer has spread within the

tissue. After the operation, your PSA level will also be


You may receive more treatment after surgery. Read

Guide 7 for more information.

Active surveillance

Some research suggests that active surveillance can

be an option for a subset of men with intermediate-

risk cancer. The subset includes men with:

1) Cancer that is mostly Gleason grade 3,

2) Cancer in less than half of the core biopsies,


3) Only one condition listed on page 46 for

intermediate risk.

Active surveillance may be considered in this subset

of men who will likely live 10 or more years. MRI and

molecular testing may assist in the decision to start

active surveillance in this group.

Active surveillance is described on page 50. Ask your

doctor about the pros and cons of active surveillance

for intermediate-risk cancer. Your doctor may want

you to be tested more often to quickly detect any

change in cancer status.