During prostate cancer patient counseling, three key tools are used by the physician, be it the urologist, oncologist or radiation specialist. These include the pre-biopsy PSA, the clinical exam stage and the highest Gleason sum recorded on the biopsy.
This information can then be inserted into predictive mathematical tools (nomograms) which are derived from thousands of men who have undergone surgery. Doctors can then calculate predictions about whether the tumor has breached the capsule (extracapsular disease), infiltrated the seminal vesicles or spread to the regional pelvic lymph nodes. The Kattan nomogram, established at Memorial Sloan-Kettering Cancer Center in New York, is commonly employed and available free, on-line.
View the Memorial Sloan-Kettering nomogram predictive staging tool.