Treatment Options For Stage 2 Prostate Cancer

Prostate cancer occurs in the prostate, a gland in the male reproductive system. Read more about prostate cancer here.

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How is prostate cancer staged?

Prostate cancer is staged using TNM method of staging cancer, a system generally used to stage cancers that form tumours. Two additional parameters, the PSA levels and the grade (depending on the Gleason score) are used to state prostate cancer.

Stage II of prostate cancer:

In this stage, the cancer has spread within the prostate involving one or both the lobes of the prostate. These cancers do not spread beyond the prostate to nearby lymph nodes or other organs. Stage II of prostate cancer is broadly categorized into three further stages:

Stage IIA:

Here, the cancer has spread upto one complete lobe of the prostate. The Gleason score of these cancer is 6 or less than 6 and PSA levels are between 10 and 20.

When the cancer is found during biopsies, and not through general diagnostic tests, it is staged as cT1, N0, M0 Grade Group 1.

When the cancer can be found to be confined to one half of a lobe of the prostate, through screening or physical examinations and has not metastasized, it is staged as cT2a or pT2, N0, M0, Grade Group 1.

If the cancer is contained in more than half of one lobe of the prostate, but has not spread, it is staged as cT2a or pT2, N0, M0, Grade Group 1.

Stage IIB:

In this stage, the cancer has not spread beyond the prostate, but is contained in more than one lobe of the prostate, with a Gleason score of 7 and PSA levels up to 20. It is staged as T1 or T2, N0, M0, Grade Group 2.

Stage IIC:

This stage of stage II cancer is staged as T1 or T2, N0, M0, Grade Group 3 or 4 with a Gleason score of 7 or 8 and PSA levels less than 20. They are spread within the prostate, with the cancer contained in both the lobes.

How is stage II prostate cancer treated?

In stage II of prostate cancer, the cancer is small and is confined to the prostate gland and the growth and spread may be slow and it may never show symptoms. The course of action depends on the age of the patient and their overall health and if they can withstand the treatment. The following are the treatment methods generally preferred for stage I prostate treatment:

Active surveillance:

Because this cancer type grows very slowly, men may often not require any treatment immediately if not throughout their lifetime. Active surveillance is a method of monitoring the cancer closely regularly. PSA blood test, DRE (digital rectal examination), prostate biopsies may be done once in six months or so. If the results show signs of the cancer spreading, the treatment options are reviewed to eliminate the cancer.

External beam radiation:

It is a type of radiation therapy, a treatment method that involves use of high beams of X rays to kill cancerous cells. In external beam radiation therapy, also called EBRT, beams of radiation are focused on the prostate gland from a machine outside the body and it is used to treat the early stages of cancer.
Read more about radiation therapy of prostate cancer here.

Brachytherapy:

Brachytherapy is a type of radiation therapy too. Also called seed implantation or interstitial radiation therapy, small radioactive pellets of the size of a grain of rice are placed directly inside the prostate gland. This treatment is used alone in patients in the early stages of cancer showing relatively slow growth. Otherwise, this is preferred in combination of other treatment methods.

Radical prostatectomy:

Surgery is the preferred choice of treatment for prostate cancers that show symptoms but is confined to the the prostate gland. The main type of surgery used is called radical prostatectomy, in which in addition to the prostate gland, the tissue around it including the seminal vesicles may be removed. Radical retropubic prostatectomy and radical perineal prostatectomy are the two types of surgeries depending on how the prostate is approached.

Read more about surgery for prostate cancer here.

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