Treatment Options For Stage 3 Prostate Cancer

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

Picture of a human examining his prostrate with a magnifying glass

How is prostate cancer staged?

Prostate cancer is staged {insert link:5.6} 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 III of prostate cancer:

Stage III of prostate cancer has spread beyond the prostate to the nearby tissues, but not to any lymph nodes or distant tissues. These cancers are mostly felt through DRE tests and are identified in screening examinations also. This stage is divided into the following 3 types:

Stage IIIA:

This stage of cancer is staged as T1 or T2, N0, M0, Grade Group 1 to 4 with a Gleason score of 8 and PSA levels of at least 20.

Stage IIIB:

In this stage, the cancer is spread to seminal vesicles (T3), or the other tissues next to the prostate, such as the urethral sphincter, rectum, bladder, and/or the wall of the pelvis (T4). It is staged as T3 or T4, N0, M0, Grade Group 1 to 4, with a Gleason score of 8 or less and any levels of PSA.

Stage IIIC:

In this stage, the cancer has spread to any of the nearby tissues, and is staged as Any T, N0, M0, Grade Group 5, with a Gleason score of 8 or 9 and any PSA levels.

How is stage II prostate cancer treated?

The treatment methods for stage III of prostate cancer include:

  • External beam radiation along with hormone therapy
  • External beam and brachytherapy with hormone therapy
  • Radical prostatectomy may or may not be followed by radiation therapy

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.

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. Read more about radiation therapy of prostate cancer here.

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.

Hormone therapy:

Hormone therapy for prostate cancer {5.14} is used when the cancer has spread too much to allow radiation or surgery or the cancer has risk of recurrence, or to shrink the cancer before radiation therapy. Also called androgen deprivation therapy or androgen suppression therapy, this treatment aims to reduce the level of androgens, the male hormones in human which stimulate growth of prostate. Hormone therapy can shrink the cancer or slow down its growth but this treatment alone cannot cure prostate cancer.

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