Prostate Cancer

Prostate cancer is a cancer that forms in tissues of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum). Prostate cancer usually occurs in older men.

The prostate is a gland in the male reproductive system located 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 produces fluid that makes up part of the semen.

 

Staging of Prostate Cancer:

 

Stage I: In stage I, cancer is found in the prostate only. The cancer:

  • is found by needle biopsy (such as 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 is not visible by imaging. 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 stage IIA and stage IIB.

In stage IIA, cancer:

  • is found by needle biopsy (such as 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 (such as 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. The PSA level is lower than 20 and the Gleason score is 7 or lower; or
  • is found in more than one-half of one lobe of the prostate. The PSA level and the Gleason score are not known.

In stage IIB, cancer:

  • is found in both lobes 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 is not visible by imaging, and the tumor has not spread outside the prostate. 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 is not visible by imaging, and the tumor has not spread outside the prostate. 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 on one or both sides 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.

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.

 

Treatment of Prostate Cancer:

 

Four types of standard treatment are used:

  • Watchful waiting
  • Surgery
  • Radiation therapy
  • Hormone therapy

 

New types of treatment are being tested in clinical trials.

 

  • Cryosurgery
  • Chemotherapy
  • Biologic therapy
  • High-intensity focused ultrasound
  • 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.

Search for clinical trials in Georgia.

Adapted from the National Cancer Institute's PDQ Database: http://www.cancer.gov/cancertopics/types/prostate. (Accessed July 2016)