Initial Treatment of Prostate Cancer by Stage

  • 4 years ago
https://www.cancer.org/cancer/prostate-cancer/treating/by-stage.html

Initial Treatment of Prostate Cancer, by Stage
The stage of your cancer is one of the most important factors in choosing the best way to treat it. Prostate cancer is staged based on the extent (how much the cancer has spread) of the cancer (using T, N, and M categories) and the PSA level and Gleason score (Grade Group) when it is first diagnosed.

For prostate cancers that haven't spread (stages I to III), doctors also use risk groups (based on how far the prostate tumor has grown, PSA level, and prostate biopsy results) to help determine treatment options. Risk groups range from very low risk to very high risk, with lower risk group cancers having a smaller chance of growing and spreading compared to those in higher risk groups.

Other factors, such as your age, overall health, life expectancy, and personal preferences are also taken into account when looking at treatment options. In fact, many doctors determine a man’s possible treatment options based not just on the stage, but on the risk of cancer coming back (recurrence) after the initial treatment and on the man’s life expectancy.

You might want to ask your doctor what factors he or she is considering when discussing your treatment options. Some doctors might recommend options that are different from those listed here.

Stage I
These prostate cancers are small (T1 or T2) and have not grown outside the prostate. They have low Gleason scores (6 or less) and low PSA levels (less than 10). They usually grow very slowly and may never cause any symptoms or other health problems.

For men without any prostate cancer symptoms who are elderly and/or have other serious health problems that may limit their lifespan, observation or active surveillance is often recommended. For men who wish to start treatment, radiation therapy (external beam or brachytherapy) or radical prostatectomy may be options.

Men who are younger and healthy may consider active surveillance (knowing that they may need to be treated later on), radical prostatectomy, or radiation therapy (external beam or brachytherapy). In some men, radical prostatectomy may be followed by radiation and a short course of hormone treatment.

Stage II
Stage II cancers have not yet grown outside of the prostate, but are larger, have higher Gleason scores, and/or have higher PSA levels than stage I cancers. Stage II cancers that are not treated with surgery or radiation are more likely than stage I cancers to eventually spread beyond the prostate and cause symptoms.

As with stage I cancers, observation is often a good option for men whose cancer is not causing any symptoms and who are elderly and/or have other serious health problems. Radiation therapy (external beam or brachytherapy) with or without a course of hormone therapy may also be an appropriate option.

Treatment options for men who are younger and otherwise healthy might include:

Radical prostatectomy (often with remo

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