The prostate cancer treatment depends on many factors including the patient’s performance status, life expectancy, comorbidities, overall stage assigned to the disease, along with other factors.
Following are the preferred treatment approaches for different stages of prostate cancer, but the final decision is taken after clinical assessment of the patient by an oncologist.
Now first let's look at the NATURAL HISTORY of prostate cancer.
|STAGE||TNM Score, PSA (ng/mL), Grade Group (GG)||TREATMENT|
T1a-2 N0 M0 PSA<10 GG=1
(Very Low to Low-Risk Disease)
|Stage I disease do not produce any symptoms and most studies suggest that active surveillance is the best approach in such cases. The patient should be screened frequently for any sign of disease progression. No other treatment is generally recommended.|
T2b-2c N0 M0 PSA<20 GG=1
T1-2 N0 M0 PSA<20 GG=3-4
As with Stage I disease, active surveillance is the first choice of treatment for elderly patients with other complications and whose life expectancy is less than 10 years.
For younger patients without any other health issue, radical prostatectomy (surgical removal of the prostate gland) and/or radiotherapy is generally recommended. In case of high PSA level or high Grade group, androgen deprivation therapy may also be employed to prevent disease recurrence.
T1-2 N0 M0 PSA>/=20 GG=1-4
Any T N0 M0 Any PSA GG=5
For Stage III disease, radiotherapy in combination with androgen deprivation therapy is considered as the standard treatment.
Radical prostatectomy followed by removal of pelvic lymph nodes and radiotherapy may also be considered.
In case of an elderly patient, less intense treatment is generally recommended. Such patients can be treated with androgen deprivation therapy alone or active surveillance may be considered if life expectancy is very low.
Any T N1 M0 Any PSA Any GG
Any T Any N M1 Any PSA Any GG
Low volume stage IV disease with limited spread of disease to bones can be treated with androgen deprivation therapy with or without radiotherapy as standard treatment.
For high volume Stage IV disease with a vast spread of disease to distant organs, chemotherapy plus androgen deprivation therapy is considered as the standard treatment.
Further treatment can be given based on the response from the initial treatment.
Palliative therapy like transurethral resection of the prostate (TURP) for bleeding and urinary obstruction or a bisphosphonate/radiopharmaceutical treatment to manage bone pain /disease can also be employed as and when required.
In the following video Cancerbro explains the difference between OBSERVATION and ACTIVE SURVEILLANCE.
Following is the brief description of various treatment types employed for prostate cancer:
In the following video, Cancerbro discusses in detail about the hormonal axis and how ANDROGEN DEPRIVATION THERAPY works in prostate cancer.
Surgical or medical castration using ADT may lead to several side effects like erectile dysfunction, a decrease in sexual desire, reduction in the size of testicles, hot flashes, breast enlargement, osteoporosis, anemia, loss of muscle mass, fatigue and depression among others.
It is very important to assess the benefits of each treatment option versus the possible risks and side effects before making a treatment decision. Sometimes patient’s choice and health condition is also important to make a treatment choice.
Following are goals of treating advanced-stage prostate cancer:
Join our PROSTATE CANCER COMMUNITY for cancer fighters and survivors across the globe.
The video below explains the TREATMENT for LOCALISED AND LOCALLY ADVANCED PROSTATE CANCER in an easy to understand manner.
When the disease progresses while the patient is on hormonal therapy, it is called as Castrate Resistant Prostate Cancer.
Watch the video below to understand the TREATMENT FOR CASTRATE RESISTANT PROSTATE CANCER in detail.
And lastly let's know about the TREATMENT OF RECURRENT PROSTATE CANCER.
Join our community of fighters and survivors, motivate and uplift each other to fight cancer together.