Stage I Prostate Cancer
Stage II Prostate Cancer
Stage III Prostate Cancer
Stage IV Prostate Cancer

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of stage I prostate cancer may include the following:

• Watchful waiting.
• Radical prostatectomy, usually with pelvic lymphadenectomy, with or without radiation therapy after surgery. It may be possible to remove the prostate without damaging nerves that are necessary for an erection.
• External-beam radiation therapy.
• Implant radiation therapy.
• A clinical trial of high-intensity focused ultrasound.
• A clinical trial of radiation therapy.
• A clinical trial testing new types of treatment.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I prostate cancer ¹.

Treatment of stage II prostate cancer may include the following:

• Radical prostatectomy, usually with pelvic lymphadenectomy, with or without radiation therapy after surgery. It may be possible to remove the prostate without damaging nerves that are necessary for an erection.
• Watchful waiting.
• External-beam radiation therapy with or without hormone therapy.
• Implant radiation therapy.
• A clinical trial of radiation therapy with or without hormone therapy.
• A clinical trial of ultrasound -guided cryosurgery.
• A clinical trial of hormone therapy followed by radical prostatectomy.
• A clinical trial testing new types of treatment.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II prostate cancer ².

Treatment of stage III prostate cancer may include the following:

• External-beam radiation therapy with or without hormone therapy.
• Hormone therapy.
• Radical prostatectomy, usually with pelvic lymphadenectomy, with or without radiation therapy after surgery.
• Watchful waiting.
• Radiation therapy, hormone therapy, or transurethral resection of the prostate as palliative therapy to relieve symptoms caused by the cancer.
• A clinical trial of radiation therapy.
• A clinical trial of ultrasound -guided cryosurgery.
• A clinical trial testing new types of treatment.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III prostate cancer ³.

Treatment of stage IV prostate cancer may include the following:

• Hormone therapy.
• External-beam radiation therapy with or without hormone therapy.
• Radiation therapy or transurethral resection of the prostate as palliative therapy to relieve symptoms caused by the cancer.
• Watchful waiting.
• A clinical trial of radical prostatectomy with orchiectomy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV prostate cancer ⁴.

Glossary Terms

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

A procedure in which tissue is frozen to destroy abnormal cells. This is usually done with a special instrument that contains liquid nitrogen or liquid carbon dioxide. Also called cryoablation.

In medicine, the swelling of the penis with blood, causing it to become firm.

A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external radiation therapy.

Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy, and hormone treatment.

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, internal radiation therapy, and radiation brachytherapy.

A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer. For a regional lymphadenectomy, some of the lymph nodes in the tumor area are removed; for a radical lymphadenectomy, most or all of the lymph nodes in the tumor area are removed. Also called lymph node dissection.

Surgery to remove one or both testicles. Also called orchidectomy.

Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.

Having to do with the pelvis (the lower part of the abdomen located between the hip bones).

Surgery to remove lymph nodes in the pelvis for examination under a microscope to see if they contain cancer.

A gland in the male reproductive system. The prostate surrounds the part of the urethra (the tube that empties the bladder) just below the bladder, and produces a fluid that forms part of the semen.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

Surgery to remove the entire prostate. The two types of radical prostatectomy are retropubic prostatectomy (surgery through an incision in the wall of the abdomen) and perineal prostatectomy (surgery through an incision between the scrotum and the anus).

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Cancer that began in the prostate and is found in the prostate only. It cannot be felt during a digital rectal exam and is not visible by imaging. It is usually found during surgery for other reasons, such as benign prostatic hyperplasia (a condition in which an overgrowth of prostate tissue occurs). The Gleason score (a number that describes how abnormal the cells look under a microscope) is low.

Cancer that began in the prostate and is more advanced than stage I, but has not grown outside the prostate. The Gleason score (a number that describes how abnormal the cells look under a microscope) can be any level.

Cancer that began in the prostate, has grown beyond the outer layer of the prostate to nearby tissues, and may be found in the seminal vesicles (glands that help produce semen). The Gleason score (a number that describes how abnormal the cells look under a microscope) can be any level.

Cancer that began in the prostate and has spread to lymph nodes near or far from the prostate, or to other parts of the body, often to the bones. The Gleason score (a number that describes how abnormal the cells look under a microscope) can be any level.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

Treatment.

A surgical procedure to remove tissue from the prostate using an instrument inserted through the urethra. Also called TURP.

A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.

Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called active surveillance, expectant management, and observation.