Prostate cancer

Prostate cancer is one of the most common types of cancer in men. Prostate cancer is usually slow growing and the goal is to identify cancer confined to the prostate gland at diagnosis. Aggressive forms of prostate cancer spread outside of the prostate gland to involve the seminal vessicles, pelvic lymph nodes, paraspinal lymph nodes (Batson's plexus) and eventually bone. Imaging is useful for identifying prostate cancer, but the aggressiveness is best identified by biopsy giving a Gleason grade. MRI can give an estimation of risk of aggresiveness by the tissue properties (single exam Pi-RADS) and with multiple exams using growth rate over time (watchful waiting) with watchful waiting performed in conjunction with serial blood testing (PSA, PCA3 etc.).