Find out about PSMA PET Imaging on Prostate Pros Podcast
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Sky (Low-Risk) is a relatively harmless condition. The biggest risk for Sky is overtreatment. Within Sky, the most favorable subtype of all (Low-Sky) is defined by all the usual Sky criteria of Gleason 3+3=6, PSA less than 10 and minimal or no palpable disease on DRE. In addition, to qualify as Low-Sky, the PSA density must be less than 0.15, there can be no more than two biopsy cores containing cancer and no single core can be more than 50 percent involved. Men in Low-Sky have the best chance for staying on surveillance long term without requiring treatment. At the other end of the spectrum (within Sky) is High-Sky which is defined by all the usual Sky criteria but with one or more of the following: palpable disease, a PSA density over 0.15 or more than 50% of the biopsy cores containing cancer. These men are at somewhat greater risk for disease progression, i.e., the eventual need to go off active surveillance and undergo treatment. Basic-Sky falls between the Low and High subtypes. As would be expected, the risk for men with Basic-Sky to require future treatment is intermediate between Low and High.