Staging | Side Effects

Treatment Options by Stage

Treatment options for early-stage prostate cancer include:

• Radical prostatectomy: surgery to remove the prostate gland and surrounding tissue and structures
• Radiation therapy: use of high-energy, external x-ray beams or internal radiation seeds to destroy cancerous tissue
• Watchful waiting: observation and monitoring of PSA levels with no immediate active treatment.
  

Treatment options for advanced prostate cancer include:

• Hormone therapy: use of drugs to inhibit the action or block the production of male hormones that cause prostate cancer to grow. Hormone therapy may include surgical removal of the testicles, which produce the male hormone testosterone.
• Radiation therapy: use of high-energy, external x-ray beams to destroy cancerous tissue
• A combination of hormone and radiation therapies
• Chemotherapy: use of toxic drugs to destroy cancer cells.
  

The treatment options below are based on the TNM system, the most widely used system in the United States for staging prostate cancer. It describes the extent of the primary tumor (T stage), the absence or presence of spread to lymph nodes (N stage) and the absence or presence of metastasis to distant tissues or organs (M stage).

Image	Stage	Treatment options
	T1a: Tumor is found "accidentally," when benign tissue is removed from an enlarged prostate. Less than 5% of the tissue removed is cancerous, more than 95% is benign.	Radical prostatectomy Radiation therapy Watchful waiting
	T1b: Tumor found "accidentally." More than 5% of tissue removed is cancerous. T1c: Tumor identified by needle biopsy performed due to elevated PSA T2a: Tumor involves no more than half of one lobe (side) of prostate T2b: Tumor involves more than half of one lobe but not both lobes T2c: Tumor involves both lobes	Radiation therapy Radical prostatectomy Watchful waiting1 No treatment until symptoms appear2 Radiation therapy2 Hormone therapy2
	T3a: Tumor involves one lobe and extends through prostatic capsule	Hormone therapy Radiation therapy Combination of hormone and radiation therapies Radical prosatectomy
	T3b: Tumor involves both lobes and extends through prostatic capsule T3c: Tumor has spread to seminal vesicles T4N0: Tumor has spread to tissues next to prostate, such as bladder, external sphincter, or pelvic wall. No lymph nodes are involved.	Hormone therapy Radiation therapy Combination of hormone and radiation therapies
	N1-3: Any T stage with lymph node involvement	Hormone therapy Chemotherapy Observation
	M1: Any T or N stage with metastasis to distant tissues or organs	Hormone therapy Chemotherapy Localized radiation for pain

¹ If life expectancy is less than 10 years (for reasons other than prostate cancer) and the tumor is probably confined to the prostate
² If life expectancy is less than 10 years (for reasons other than prostate cancer) and the tumor has probably extended beyond the prostate
* Treatment options are listed in no specific order

More information:

• Determining Your Choice of Treatment

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The Prostate Cancer pages of this Web site are part of the Comprehensive Prostate Cancer Awareness Program (CPCAP), a major regional effort to reduce the rates of death and illness caused by prostate cancer in southwestern Pennsylvania. Funding for CPCAP is provided by a grant from the Commonwealth of Pennsylvania.

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