PSA Screening, Gleason Grading and Treatment in Prostate Cancer: A Review
Mohammed Anwar
2025-12-19
2026-02-25
2026-03-01
Abstract
Worldwide prostate cancer is the most commonly diagnosed non-cutaneous malignancy and the second leading cause cancer death in men in developed countries. Management of prostate cancer has seen significant advancement over the decades. Three key components are prostate-specific antigen (PSA) screening; the Gleason grading system; and androgen deprivation therapy. These have been important for disease diagnosis, risk assessment and treatment. While early detection is enabled by the PSA screening, it is still controversial for over diagnosis and overtreatment. The Gleason grading system, recently updated to the Grade Group system, aids in pronouncing an important prognosis and in treatment decision-making. Androgen deprivation therapy, on very much a portas de of prostate cancer being androgen-dependent, remains the mainstay of treatment for the advanced disease despite significant side effects and the eventual development of castration-resistant disease. Evaluation of evidence regarding the use of PSA as a screening and monitoring tool, a review of the clinical and historical development of Gleason/Grade Group grading and an understanding of mechanisms, indications, effectiveness, and adverse effects of androgen deprivation therapy are described. To optimize screening, risk stratification, and treatment approaches capable of balancing oncological control with quality of life, it is essential to understand these key factors.
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