There is no “one size fits all” treatment when it comes to prostate cancer. Treatment of prostate cancer is based on the stage of the cancer when it is diagnosed. Staging is performed for two purposes – to guide initial treatment decisions and to predict the patient’s survival outcome after therapy. Prostate cancer staging itself is based on a number of different factors, including prostate cancer screening tests such as a digital rectal exam or prostate-specific antigen (PSA) test and imaging studies like bone scans or MRIs. Some of the different treatment options for the various prostate cancer stages are described below:
Stage I describes a cancer that is confined within the prostate gland and has not spread to the nearby lymph nodes. These cancers can be slow growing, remaining confined to the prostate and not causing any symptoms and often “watchful waiting” is recommended. Watchful waiting is a way of monitoring prostate cancer that isn’t causing any symptoms or problems. The goal is to keep an eye on the cancer over the long term, and avoid treatment unless you get symptoms.
At this stage the tumor is more advanced or has a higher grade than in Stage I, but the tumor hasn’t extend beyond the prostate. It may be felt during a digital rectal exam, or it may be seen on a sonogram. In younger men that are otherwise healthy, treatment with surgery and radiotherapy are considered appropriate treatment options.
At stage III the tumor has spread beyond the prostate. The tumor may have invaded the seminal vesicles, but cancer cells haven’t spread to the lymph nodes. Treatment options at this stage may include: external beam radiation plus hormone therapy, radiation (external beam plus brachytherapy) and radical prostatectomy.
A stage IV cancer has either spread beyond the prostate to nearby structures other than the seminal vesicles, or to the lymph nodes, to distant sites in the body or to a combination of all three. Most stage IV cancers can’t be cured, but are treatable. The goals of treatment are to keep the cancer under control for as long as possible and to improve a man’s quality of life. Treatment options for stage IV prostate cancer may include: hormone therapy, TURP (transurethral resection of prostate) procedure to ease symptoms, external beam radiation and radical prostatectomy.