Prostate Cancer
General Information(Symptoms and DIagnosis)
Stages of Prostate Cancer
Treatment Options
The prostate gland makes fluid that forms part of semen. The
prostate lies just below the bladder in front of the rectum. It
surrounds the urethra (the tube that carries urine and semen through
the penis and out of the body).
Prostate cancer is the most common cancer in men in the United
States, after skin cancer. It is the second leading cause of death from
cancer in men. Prostate cancer occurs more often in African-American
men than in white men. African-American men with prostate cancer are
more likely to die from the disease than white men with prostate cancer.
Almost all prostate cancers are adenocarcinomas (cancers that
begin in cells that make and release mucus and other fluids). Prostate
cancer often has no early symptoms. Advanced prostate cancer can cause
men to urinate more often or have a weaker flow of urine, but these
symptoms can also be caused by benign prostate conditions.
Prostate cancer usually grows very slowly. Most men with
prostate cancer are older than 65 years and do not die from the
disease. Finding and treating prostate cancer before symptoms occur may
not improve health or help you live longer. Talk to your doctor about
your risk of prostate cancer and whether you need screening tests.
General Information About Prostate Cancer
Key Points
- Prostate cancer is a disease in which malignant (cancer)
cells form in the tissues of the prostate.
- Signs of prostate cancer include a weak flow of urine or
frequent urination.
- Tests that examine the prostate and blood are used to
detect (find) and diagnose prostate cancer.
- Certain factors affect prognosis (chance of recovery) and
treatment options.
Prostate
cancer is a disease in which malignant (cancer) cells form in the
tissues of the prostate.
The prostate is a gland in the male reproductive system. It lies
just below the bladder
(the organ that
collects and empties urine)
and in front of the rectum
(the lower part of the intestine).
It is about the size of a walnut and surrounds part of the urethra (the tube that
empties urine from the bladder). The prostate gland makes fluid that is part of the semen.
Anatomy of the male
reproductive and urinary systems, showing the prostate, testicles,
bladder, and other organs.
Prostate cancer is most
common in older men. In the U.S., about 1 out of 5 men will be diagnosed with prostate
cancer.
Signs
of prostate cancer include a weak flow of urine or frequent urination.
These and other signs and symptoms may be caused by
prostate cancer or by other conditions.
Check with your doctor if you have any of the following:
- Weak or interrupted ("stop-and-go") flow of urine.
- Sudden urge to urinate.
- Frequent urination (especially at night).
- Trouble starting the flow of urine.
- Trouble emptying the bladder completely.
- Pain or burning while urinating.
- Blood
in the urine or semen.
- A pain in the back, hips, or pelvis
that doesn't go away.
- Shortness of breath, feeling very tired, fast heartbeat,
dizziness, or pale skin caused by anemia.
Other conditions may
cause the same symptoms. As men age, the prostate may get bigger and
block the urethra or bladder. This may cause trouble urinating or
sexual problems. The condition is called benign
prostatic hyperplasia (BPH), and although it is not
cancer, surgery may
be needed. The symptoms of benign prostatic hyperplasia or of other
problems in the prostate may be like symptoms of prostate cancer.
Normal prostate and benign
prostatic hyperplasia (BPH). A normal prostate does not block the flow
of urine from the bladder. An enlarged prostate presses on the bladder
and urethra and blocks the flow of urine.
Tests
that examine the prostate and blood are used to detect (find) and
diagnose prostate cancer.
The following tests and
procedures may be used:
- Physical
exam and history
: An exam of the body to check general signs of
health, including checking for signs of disease, such as lumps or
anything else that seems unusual. A history of the patient's health
habits and past illnesses and treatments will also be taken.
- Digital
rectal exam (DRE): An exam of the rectum.
The doctor or nurse
inserts a lubricated, gloved finger into the rectum and feels the
prostate through the rectal wall for lumps or abnormal areas.
Digital rectal exam
(DRE). The doctor inserts a gloved, lubricated finger into the rectum
and feels the prostate to check for anything abnormal.
- Prostate-specific
antigen (PSA) test : A test that measures
the level of PSA in
the blood. PSA is a substance made by the prostate that may be found in
an increased amount in the blood of men who have prostate cancer. PSA
levels may also be high in men who have an infection
or inflammation of
the prostate or BPH (an enlarged, but noncancerous, prostate).
- Transrectal
ultrasound : A procedure in which a probe that is about the size
of a finger is inserted into the rectum to check the prostate. The
probe is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make
echoes. The echoes form a picture of body tissues called a sonogram. Transrectal
ultrasound may be used during a biopsy
procedure.
Transrectal ultrasound.
An ultrasound probe is inserted into the rectum to check the prostate.
The probe bounces sound waves off body tissues to make echoes that form
a sonogram (computer picture) of the prostate.
- Transrectal magnetic
resonance imaging (MRI): A procedure that
uses a strong magnet, radio waves,
and a computer to make a series of detailed pictures of areas inside
the body. A probe that gives off radio waves is inserted into the
rectum near the prostate. This helps the MRI machine make clearer
pictures of the prostate and nearby tissue. A transrectal MRI is done
to find out if the cancer has spread outside the prostate into nearby
tissues. This procedure is also called nuclear magnetic resonance
imaging (NMRI).
- Biopsy: The removal of cells or tissues so they can
be viewed under a microscope
by a pathologist.
The pathologist will check the tissue sample to see if there are cancer
cells and find out the Gleason
score. The Gleason score ranges from 2-10 and describes
how likely it is that a tumor
will spread. The lower the number, the less likely the tumor is to
spread.
A transrectal biopsy is used
to diagnose prostate cancer. A transrectal biopsy is the removal of
tissue from the prostate by inserting a thin needle through the rectum
and into the prostate. This procedure is usually done using transrectal
ultrasound to help guide where samples of tissue are taken from. A
pathologist views the tissue under a microscope to look for cancer
cells.
Transrectal biopsy. An
ultrasound probe is inserted into the rectum to show where the tumor
is. Then a needle is inserted through the rectum into the prostate to
remove tissue from the prostate.
Certain
factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment
options depend on the following:
- The stage
of the cancer (level of PSA, Gleason score, grade of the tumor, how
much of the prostate is affected by the cancer, and whether the cancer
has spread to other places in the body).
- The patient's age.
- Whether the cancer has just been diagnosed or has recurred (come back).
Treatment options also
may depend on the following:
- Whether the patient has other health problems.
- The expected side
effects of treatment.
- Past treatment for prostate cancer.
- The wishes of the patient.
Most men diagnosed with
prostate cancer do not die of it.
Stages of Prostate Cancer
Key Points
- After prostate cancer has been diagnosed, tests are done to
find out if cancer cells have spread within the prostate or to other
parts of the body.
- There are three ways that cancer spreads in the body.
- Cancer may spread from where it began to other parts of the
body.
- The following stages are used for prostate cancer:
- Stage I
- Stage II
- Stage III
- Stage IV
After
prostate cancer has been diagnosed, tests are done to find out if
cancer cells have spread within the prostate or to other parts of the
body.
The process used to find
out if cancer has
spread within the prostate
or to other parts of the body is called staging.
The information gathered from the staging process determines the stage of the disease. It is
important to know the stage in order to plan treatment. The results of
the tests used to diagnose
prostate cancer are
often also used to stage the disease. (See the General Information
section.) In prostate cancer, staging tests may not be done unless the
patient has symptoms
or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score.
The following tests and
procedures also may be used in the staging process:
The stage of the cancer
is based on the results of the staging and diagnostic
tests, including the prostate-specific
antigen (PSA) test and the Gleason score. The tissue
samples removed during the biopsy are used to find out the Gleason
score. The Gleason score ranges from 2-10 and describes how different
the cancer cells look from normal cells and how likely it is that the tumor will spread. The lower
the number, the less likely the tumor is to spread.
There
are three ways that cancer spreads in the body.
Cancer can spread
through tissue, the
lymph system, and
the blood:
- Tissue. The cancer spreads from where it began by growing
into nearby areas.
- Lymph system. The cancer spreads from where it began by
getting into the lymph system. The cancer travels through the lymph vessels to other parts
of the body.
- Blood. The cancer spreads from where it began by getting
into the blood. The cancer travels through the blood vessels to other parts
of the body.
Cancer
may spread from where it began to other parts of the body.
When cancer spreads
to another part of the body, it is called metastasis.
Cancer cells break
away from where they began (the primary
tumor) and travel through the lymph system or blood.
- Lymph system. The cancer gets into the lymph system,
travels through the lymph vessels, and forms a tumor (metastatic tumor) in another
part of the body.
- Blood. The cancer gets into the blood, travels through the
blood vessels, and forms a tumor (metastatic tumor) in another part of
the body.
The metastatic tumor is
the same type of cancer as the primary tumor. For example, if prostate
cancer spreads to the bone, the cancer cells in the bone are actually
prostate cancer cells. The disease is metastatic prostate cancer, not
bone cancer.
Denosumab, a monoclonal antibody, may be
used to prevent bone metastases.
The
following stages are used for prostate cancer:
As prostate cancer
progresses from Stage I to Stage IV, the cancer cells grow within the
prostate, through the outer layer of the prostate into nearby tissue,
and then to lymph nodes or other parts of the body.
Stage
I
In stage I, cancer is found in the prostate only. The cancer:
- is found by needle
biopsy (done for a high PSA
level) or in a small amount of tissue
during surgery for
other reasons (such as benign
prostatic hyperplasia). The PSA level is lower than 10 and
the Gleason score
is 6 or lower; or
- is found in one-half or less of one lobe of the prostate. The
PSA level is lower than 10 and the Gleason score is 6 or lower; or
- cannot be felt during a digital
rectal exam and cannot be seen in imaging tests. Cancer is
found in one-half or less of one lobe of the prostate. The PSA level
and the Gleason score are not known.
Stage
II
In stage II, cancer is more advanced than
in stage I, but has
not spread outside the prostate.
Stage II is divided into stages IIA and IIB.
In stage IIA, cancer:
- is found by needle
biopsy (done for a high PSA
level) or in a small amount of tissue
during surgery for
other reasons (such as benign
prostatic hyperplasia). The PSA level is lower than 20 and
the Gleason score
is 7; or
- is found by needle biopsy (done for a high PSA level) or
in a small amount of tissue during surgery for other reasons (such as
benign prostatic hyperplasia). The PSA level is at least 10 but lower
than 20 and the Gleason score is 6 or lower; or
- is found in one-half or less of one lobe of the prostate. The PSA level is
at least 10 but lower than 20 and the Gleason score is 6 or lower; or
- is found in one-half or less of one lobe of the prostate.
The PSA level is lower than 20 and the Gleason score is 7; or
- is found in more than one-half of one lobe of the prostate.
In stage IIB, cancer:
- is found in opposite sides of the prostate. The PSA can be any level and the
Gleason score
can range from 2 to 10; or
- cannot be felt during a digital
rectal exam and cannot be seen in imaging tests. The PSA level
is 20 or higher and the Gleason score can range from 2 to 10; or
- cannot be felt during a digital rectal exam and cannot be
seen in imaging tests. The PSA can be any level and the Gleason score
is 8 or higher.
Stage
III
In stage III, cancer has spread beyond the
outer layer of the prostate
and may have spread to the seminal
vesicles. The PSA
can be any level and the Gleason
score can range from 2 to 10.
Stage
IV
In stage IV, the PSA can be any level and the
Gleason score can
range from 2 to 10. Also, cancer:
- has spread beyond the seminal
vesicles to nearby tissue
or organs, such as
the rectum, bladder, or pelvic wall; or
- may have spread to the seminal vesicles or to nearby tissue
or organs, such as the rectum, bladder, or pelvic wall. Cancer has
spread to nearby lymph nodes;
or
- has spread to distant parts of the body, which may include
lymph nodes or bones. Prostate
cancer often spreads to the bones.
Recurrent Prostate Cancer
Recurrent prostate cancer is cancer that has recurred
(come back) after it has been treated. The cancer may come back in the prostate or in other parts
of the body.
Treatment Option Overview
Key Points
- There are different types of treatment for patients with
prostate cancer.
- Seven types of standard treatment are used:
- Watchful waiting or active surveillance
- Surgery
- Radiation therapy and radiopharmaceutical therapy
- Hormone therapy
- Chemotherapy
- Biologic therapy
- Bisphosphonate therapy
- There are treatments for bone pain caused by bone
metastases or hormone therapy.
- New types of treatment are being tested in clinical trials.
- Cryosurgery
- High-intensity-focused ultrasound therapy
- Proton beam radiation therapy
- Patients may want to think about taking part in a clinical
trial.
- Patients can enter clinical trials before, during, or after
starting their cancer treatment.
- Follow-up tests may be needed.
There
are different types of treatment for patients with prostate cancer.
Different types of
treatment are available for patients with prostate
cancer. Some treatments are standard
(the currently used treatment), and some are being tested in clinical trials. A treatment
clinical trial is a research
study meant to help improve current treatments or obtain
information on new treatments for patients with cancer. When clinical trials
show that a new treatment is better than the standard treatment, the
new treatment may become the standard treatment. Patients may want to
think about taking part in a clinical trial. Some clinical trials are
open only to patients who have not started treatment.
Seven
types of standard treatment are used:
Watchful
waiting or active surveillance
Watchful waiting and active surveillance are
treatments used for older men who do not have signs or symptoms or have other
medical conditions
and for men whose prostate cancer is found during a screening test.
Watchful waiting is
closely monitoring
a patient's condition
without giving any treatment until signs or symptoms appear or change.
Treatment is given to relieve symptoms and improve quality of life.
Active surveillance is
closely following a patient's condition without giving any treatment
unless there are changes in test results. It is used to find early
signs that the condition is getting worse. In active surveillance,
patients are given certain exams and tests, including digital rectal exam, PSA test, transrectal ultrasound, and
transrectal needle biopsy,
to check if the cancer is growing. When the cancer begins to grow,
treatment is given to cure
the cancer.
Other terms that are
used to describe not giving treatment to cure prostate cancer right
after diagnosis are
observation, watch and wait, and expectant management.
Surgery
Patients in good health
whose tumor is in
the prostate gland only may be treated
with surgery to
remove the tumor. The following types of surgery are used:
- Radical
prostatectomy: A surgical procedure to remove the
prostate, surrounding tissue,
and seminal vesicles.
There are two types of radical prostatectomy:
- Retropubic
prostatectomy: A surgical procedure to remove the prostate
through an incision
(cut) in the abdominal
wall. Removal of nearby lymph
nodes may be done at the same time.
- Perineal
prostatectomy: A surgical procedure to remove the prostate
through an incision (cut) made in the perineum
(area between the scrotum
and anus). Nearby
lymph nodes may also be removed through a separate incision in the abdomen.
Two types of radical
prostatectomy. In a retropubic prostatectomy, the prostate is removed
through an incision in the wall of the abdomen. In a perineal
prostatectomy, the prostate is removed through an incision in the area
between the scrotum and the anus.
- Pelvic
lymphadenectomy: A surgical procedure to remove the lymph
nodes in the pelvis.
A pathologist views
the tissue under a microscope
to look for cancer cells.
If the lymph nodes contain cancer, the doctor will not remove the
prostate and may recommend other treatment.
- Transurethral
resection of the prostate (TURP): A surgical procedure to
remove tissue from the prostate using a resectoscope
(a thin, lighted tube with a cutting tool) inserted through the urethra. This procedure is
done to treat benign prostatic
hypertrophy and it is sometimes done to relieve symptoms
caused by a tumor
before other cancer treatment is given. TURP may also be done in men
whose tumor is in the prostate only and who cannot have a radical
prostatectomy.
Transurethral resection
of the prostate (TURP). Tissue is removed from the prostate using a
resectoscope (a thin, lighted tube with a cutting tool at the end)
inserted through the urethra. Prostate tissue that is blocking the
urethra is cut away and removed through the resectoscope.
In some cases, nerve-sparing surgery can be
done. This type of surgery may save the nerves
that control erection.
However, men with large tumors or tumors that are very close to the
nerves may not be able to have this surgery.
Possible problems after
prostate cancer surgery include the following:
- Impotence.
- Leakage of urine
from the bladder or
stool from the rectum.
- Shortening of the penis
(1 to 2 centimeters).
The exact reason for this is not known.
- Inguinal hernia
(bulging of fat or part of the small
intestine through weak muscles into the groin). Inguinal hernia may
occur more often in men treated with radical prostatectomy than in men
who have some other types of prostate surgery, radiation therapy, or
prostate biopsy
alone. It is most likely to occur within the first 2 years after
radical prostatectomy.
Radiation
therapy and radiopharmaceutical therapy
Radiation therapy is a
cancer treatment that uses high-energy x-rays
or other types of radiation
to kill cancer cells or keep them from growing. There are different
types of radiation therapy:
- External radiation
therapy uses a machine outside the body to send radiation
toward the cancer. Conformal
radiation is a type of external radiation therapy that
uses a computer to make a 3-dimensional
(3-D) picture of the tumor and shapes the radiation beams to fit the
tumor. This allows a high dose of radiation to reach the tumor and
causes less damage to nearby healthy tissue.
Hypofractionated radiation therapy
may be given because it has a more convenient treatment schedule.
Hypofractionated radiation therapy is radiation treatment in which a
larger than usual total dose
of radiation is given once a day over a shorter period of time (fewer
days) compared to standard radiation therapy. Hypofractionated
radiation therapy may have worse side effects than standard radiation
therapy, depending on the schedules used.
- Internal radiation
therapy uses a radioactive
substance sealed in needles, seeds,
wires, or catheters
that are placed directly into or near the cancer. In early-stage prostate cancer,
the radioactive seeds are placed in the prostate using needles that are
inserted through the skin between the scrotum and rectum. The placement
of the radioactive seeds in the prostate is guided by images from transrectal ultrasound or computed tomography (CT).
The needles are removed after the radioactive seeds are placed in the
prostate.
- Radiopharmaceutical
therapy uses a radioactive substance to
treat cancer. Radiopharmaceutical therapy includes the following:
- Alpha emitter
radiation therapy uses a radioactive substance to treat
prostate cancer that has spread to the bone. A radioactive substance
called radium-223
is injected into a vein and travels through the
bloodstream. The radium-223 collects in areas of bone with cancer and
kills the cancer cells.
The way the radiation
therapy is given depends on the type and stage
of the cancer being treated. External radiation therapy, internal
radiation therapy, and radiopharmaceutical therapy are used to treat
prostate cancer.
Men treated with
radiation therapy for prostate cancer have an increased risk of having bladder and/or gastrointestinal cancer.
Radiation therapy can
cause impotence and
urinary problems.
Hormone
therapy
Hormone therapy is a cancer
treatment that removes hormones
or blocks their action and stops cancer cells from growing. Hormones
are substances made by glands
in the body and circulated in the bloodstream. In prostate cancer, male
sex hormones can cause prostate cancer to grow. Drugs, surgery, or other
hormones are used to reduce the amount of male hormones or block them
from working.
Hormone therapy for
prostate cancer may include the following:
- Luteinizing
hormone-releasing hormone agonists can stop the testicles from making testosterone. Examples are leuprolide, goserelin, and buserelin.
- Antiandrogens
can block the action of androgens
(hormones that promote male sex characteristics), such as testosterone.
Examples are flutamide,
bicalutamide, enzalutamide, and nilutamide.
- Drugs that can prevent the adrenal
glands from making androgens include ketoconazole and aminoglutethimide.
- Orchiectomy
is a surgical procedure to remove one or both testicles, the main
source of male hormones, such as testosterone, to decrease the amount
of hormone being made.
- Estrogens
(hormones that promote female sex characteristics) can prevent the
testicles from making testosterone. However, estrogens are seldom used
today in the treatment of prostate cancer because of the risk of
serious side effects.
Hot flashes, impaired sexual function,
loss of desire for sex, and weakened bones may occur in men treated
with hormone therapy. Other side
effects include diarrhea,
nausea, and itching.
See Drugs Approved for
Prostate Cancer for more information.
Chemotherapy
Chemotherapy is a cancer
treatment that uses drugs to stop the growth of cancer cells, either by
killing the cells or by stopping them from dividing. When chemotherapy
is taken by mouth or injected
into a vein or
muscle, the drugs enter the bloodstream and can reach cancer cells
throughout the body (systemic
chemotherapy). When chemotherapy is placed directly into
the cerebrospinal fluid,
an organ, or a body
cavity such as the abdomen, the drugs mainly
affect cancer cells in those areas (regional
chemotherapy). The way the chemotherapy is given depends
on the type and stage of the cancer being treated.
See Drugs Approved for
Prostate Cancer for more information.
Biologic
therapy
Biologic therapy is a
treatment that uses the patient's immune
system to fight cancer. Substances made by the body or
made in a laboratory are used to boost, direct, or restore the body's
natural defenses against cancer. Sipuleucel-T
is a type of biologic therapy used to treat prostate cancer that has metastasized (spread to
other parts of the body).
See Drugs Approved for
Prostate Cancer for more information.
Bisphosphonate
therapy
Bisphosphonate drugs, such
as clodronate or zoledronate, reduce bone
disease when cancer has spread to the bone. Men who are treated with
antiandrogen therapy or orchiectomy are at an increased risk of bone
loss. In these men, bisphosphonate drugs lessen the risk of bone
fracture (breaks). The use of bisphosphonate drugs to prevent or slow
the growth of bone metastases
is being studied in clinical trials.
There
are treatments for bone pain caused by bone metastases or hormone
therapy.
Prostate cancer that has
spread to the bone and certain types of hormone therapy can weaken
bones and lead to bone pain. Treatments for bone pain include the
following:
- Pain medicine.
- External radiation therapy.
- Strontium-89
(a radioisotope).
- Targeted therapy
with a monoclonal antibody,
such as denosumab.
- Bisphosphonate therapy.
- Corticosteroids.
See the PDQ summary on Pain for more
information.
New
types of treatment are being tested in clinical trials.
This summary section
describes treatments that are being studied in clinical trials. It may
not mention every new treatment being studied. Information about
clinical trials is available from the NCI website.
Cryosurgery
Cryosurgery is a treatment
that uses an instrument to freeze and destroy prostate cancer cells.
Ultrasound is used to find the area that will be treated. This type of
treatment is also called cryotherapy.
Cryosurgery can cause
impotence and leakage of urine from the bladder or stool from the
rectum.
High-intensity-focused
ultrasound therapy
High-intensity-focused ultrasound therapy
is a treatment that uses ultrasound (high-energy sound waves) to
destroy cancer cells. To treat prostate cancer, an endorectal probe is used to make the
sound waves.
Proton
beam radiation therapy
Proton beam radiation therapy
is a type of high-energy, external radiation therapy that targets
tumors with streams of protons
(small, positively charged particles). This type of radiation therapy
is being studied in the treatment of prostate cancer.
Patients
may want to think about taking part in a clinical trial.
For some patients,
taking part in a clinical trial
may be the best treatment choice. Clinical trials are part of the
cancer research process. Clinical trials are done to find out if new
cancer treatments are safe and effective or better than the standard treatment.
Many of today's
standard treatments for cancer are based on earlier clinical trials.
Patients who take part in a clinical trial may receive the standard
treatment or be among the first to receive a new treatment.
Patients who take
part in clinical trials also help improve the way cancer will be
treated in the future. Even when clinical trials do not lead to
effective new treatments, they often answer important questions and
help move research forward.
Patients
can enter clinical trials before, during, or after starting their
cancer treatment.
Some clinical trials
only include patients who have not yet received treatment. Other trials
test treatments for patients whose cancer has not gotten better. There
are also clinical trials that test new ways to stop cancer from recurring (coming back) or
reduce the side effects
of cancer treatment.
Clinical trials are
taking place in many parts of the country. See the Treatment Options
section that follows for links to current treatment clinical trials.
These have been retrieved from NCI's
listing of clinical trials.
Follow-up
tests may be needed.
Some of the tests
that were done to diagnose
the cancer or to find out the stage
of the cancer may be repeated. Some tests will be repeated in order to
see how well the treatment is working. Decisions about whether to
continue, change, or stop treatment may be based on the results of
these tests.
Some of the tests
will continue to be done from time to time after treatment has ended.
The results of these tests can show if your condition
has changed or if the cancer has recurred
(come back). These tests are sometimes called follow-up tests or check-ups.
Treatment Options by Stage
Stage I Prostate Cancer
Standard treatment of stage I prostate cancer may
include the following:
- Watchful waiting.
- Active surveillance.
If the cancer
begins to grow, hormone therapy
may be given.
- Radical
prostatectomy, usually with pelvic
lymphadenectomy.
Radiation therapy
may be given after surgery.
- External radiation
therapy. Hormone therapy may be given after radiation
therapy.
- Internal radiation
therapy with radioactive
seeds.
- A clinical trial
of high-intensity-focused
ultrasound therapy.
- A clinical trial of cryosurgery.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage I prostate cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI website.
Stage II Prostate Cancer
Standard treatment of stage II prostate cancer may
include the following:
- Watchful waiting.
- Active surveillance.
If the cancer
begins to grow, hormone therapy
may be given.
- Radical
prostatectomy, usually with pelvic
lymphadenectomy. Radiation
therapy may be given after surgery.
- External radiation
therapy. Hormone therapy may be given after radiation
therapy.
- Internal radiation
therapy with radioactive
seeds.
- A clinical trial
of cryosurgery.
- A clinical trial of high-intensity-focused
ultrasound therapy.
- A clinical trial of proton
beam radiation therapy.
- Clinical trials of new types of treatment, such as hormone
therapy followed by radical prostatectomy.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage II prostate cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI website.
Stage III Prostate Cancer
Standard treatment of stage III prostate cancer
may include the following:
- External radiation
therapy. Hormone
therapy may be given after radiation
therapy.
- Hormone therapy.
- Radical
prostatectomy. Radiation therapy may be given after surgery.
- Watchful waiting.
- Active surveillance.
If the cancer
begins to grow, hormone therapy may be given.
Treatment to control
cancer that is in the prostate
and lessen urinary symptoms may include the
following:
- External radiation therapy.
- Internal radiation
therapy with radioactive
seeds.
- Hormone therapy.
- Transurethral
resection of the prostate (TURP).
- A clinical trial
of new types of radiation therapy.
- A clinical trial of cryosurgery.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage III prostate cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI website.
Stage IV Prostate Cancer
Standard treatment of stage IV prostate cancer may
include the following:
- Hormone therapy.
- Hormone therapy combined with chemotherapy.
- Bisphosphonate
therapy.
- External radiation
therapy. Hormone therapy may be given after radiation therapy.
- Alpha emitter
radiation therapy.
- Watchful waiting.
- Active surveillance.
If the cancer
begins to grow, hormone therapy may be given.
- A clinical trial
of radical prostatectomy
with orchiectomy.
Treatment to control
cancer that is in the prostate
and lessen urinary symptoms may include the
following:
- Transurethral
resection of the prostate (TURP).
- Radiation therapy.
Treatment Options for Recurrent Prostate Cancer
Standard treatment of recurrent prostate cancer may include
the following:
- Hormone therapy.
- Chemotherapy
for patients already treated with hormone therapy.
- Biologic therapy
with sipuleucel-T
for patients already treated with hormone therapy.
- External radiation
therapy.
- Prostatectomy
for patients already treated with radiation therapy.
- Alpha emitter
radiation therapy.
-NIH