Rolling Stones’ Bill Wyman Diagnosed with Prostate Cancer
The cancer was caught in the early stages and the bass player is expected to make a full recovery.
Bill Wyman, bassist for the the Rolling Stones from 1962 until 1993, has been diagnosed with prostate cancer. It was announced in a statement from his representative:
"Bill Wyman, former member of the Rolling Stones, has been diagnosed with prostate cancer. He is undergoing treatment and is expected to make a full recovery as it was caught in the early stages. The Wyman family has asked for their privacy during this time. No further comment will be made at this point."
Since 1997, Wyman has recorded and toured with his own band, Bill Wyman's Rhythm Kings. He has also worked producing both records and film, and has scored music for film in movies and television.
Basic information about prostate cancer can be found in our story about former WWE wrestler Bret Hart. This article will cover the grading of prostate cancer. Grading may be one of the most important factors in deciding just what kind of treatment you may receive, or whether you actually need treatment at all.
The Grading of Tumors
After a diagnosis of cancer, but before treatment begins, a patient almost always goes through a process called grading and staging that will determine the type of treatment, the intensity of treatment, and how long treatments will have to continue.
A pathologist will examine your biopsy specimen under a microscope to check for cancer cells and abnormal patterns of growth (the “architecture” of the tumor). If cancer is found, the pathologist will also assign a grade to your tumor using a special grading scale.
Unlike in school, a higher grade is not a better grade. Tumor grades are more like golf scores – the lower the better.
There are different grading systems for different types of cancer. In general, tumors are graded on this type of scale:
GX: Grade cannot be assessed (undetermined grade)
G1: Well differentiated (low-grade)
G2: Moderately differentiated (intermediate-grade)
G3: Poorly differentiated (high-grade)
G4: Undifferentiated (high-grade)
Low-grade tumors are described as well-differentiated because they clearly resemble the normal tissue (e.g. prostate glands) in which the tumor arose. High-grade tumors look undifferentiated, meaning that the tumor cells and architecture resemble barely the normal tissue they came from.
More than a century ago, doctors discovered that a tumor’s grade was a good predictor of its tenacity and aggressiveness. In other words, the higher the grade, the more difficult it was to treat the cancer with a less favorable prognosis for the patient.
Prostate Cancer Grading Systems
The traditional grading system for prostate cancer is called a Gleason score, named after a Minnesota pathologist, Dr. Donald Gleason, who first devised his system at the Minneapolis VA Medical Center in the late 1960s and early 1970s.
The Gleason score is based on biopsy samples taken from the prostate. The pathologist checks the samples to see how similar the tumor tissue looks to normal prostate tissue. Both a primary and a secondary pattern of tissue organization are identified. The primary pattern represents the most common tissue pattern seen in the tumor, and the secondary pattern represents the next most common pattern. Each pattern is given a grade from 1 to 5, with 1 looking the most like normal prostate tissue and 5 looking the most abnormal (see diagram). The two grades are then added to give a Gleason score. The American Joint Committee on Cancer recommends grouping Gleason scores into the following categories:
Gleason X: Gleason score cannot be determined
Gleason 2–6: The tumor tissue is well differentiated
Gleason 7: The tumor tissue is moderately differentiated
Gleason 8–10: The tumor tissue is poorly differentiated or undifferentiated
The rise of widespread PSA (prostate specific antigen) testing in the 1990s led to unintended “grade inflation.” This resulted in low-grade cancers being upgraded to higher-grade tumors.
The Gleason grading system underwent major revisions in 2005 and again in 2014 but has grown even more complex and confusing for both doctors and patients. Both the World Health Organization (WHO) and the International Society of Urological Pathology (ISUP) have accepted a new grading system pioneered by Dr. Jonathan Epstein, a professor of Pathology, Oncology and Urology at the Johns Hopkins Medical Institutions in Baltimore, Maryland.
Dr. Epstein’s system consists of just five grades and some find it clearer than the Gleason system. Here’s a summary of the Epstein systemActive surveillance may be the best course of action for Epstein Grade 1 tumors. Grades 2, 3, 4 and 5 in the Epstein system have progressively less favorable prognoses and are candidates for more intensified treatments.
It is going to take some time before the new system is widely used. Until that time, don’t be surprised to see a Gleason score also assigned to your cancer.
Want to check your risk for prostate cancer? Chick here to use this prostate cancer risk assessment tool from the University of Texas.
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