Therapeutic Options Based on Cancer Stage
by Trevor Mulholland
It is important for men to know their options when it comes to prostate treatments specific to a cancer's stage. Staging is used to describe the extent by which a cancer has spread. In prostate cancer, the most commonly used staging system is called the TNM. The overall stage under the TNM system is expressed in Roman numerals. The least advanced condition is tagged as Stage I, while the most advanced is categorized as Stage IV.
In considering prostate treatments, doctors usually look at the stage of the patient's cancer and his Gleason score and prostate specific antigen level results. Other factors such as age, life expectancy, other disorders suffered from by the patient (if any) and risk of cancer recurrence after treatment are also important factors in choosing treatment options.
Cancers that are categorized as Stage I are usually small and have low Gleason scores. They grow slowly and may not produce any symptom or create health problems. For older men who have cancer categorized as Stage I, watchful waiting or radiation therapy are the most common options. These treatment methods are also recommended to those who have other serious health problems. For men who are younger and have no other serious disorders, watchful waiting, radical prostatectomy and radiation therapy are viable options.
Compared with Stage I prostate cancers, Stage II usually manifest symptoms and has a higher possibility of spreading beyond the prostate. For elderly men and for those who suffer from other serious diseases, watchful waiting is the best option, although radical prostatectomy and radiation therapy can also be considered. For younger, healthy men with Stage II cancer, treatment options include radical prostatectomy, which could involve the removal of the pelvic lymph nodes and is sometimes preceded by hormone therapy; external radiation; brachytherapy; combined brachytherapy and external beam radiation; and radical prostatectomy to be followed by external beam radiation if the patient has a high Gleason score. In Stage II, all radiation options may be accompanied by three to six months of hormone therapy.
Stage III cancers are those that have spread beyond the prostate gland but have not reached the bladder, rectum, lymph nodes or distant organs. Treatment options for Stage III include external beam radiation plus hormone therapy; hormone therapy only; radical prostatectomy in selected cases which may be followed by radiation therapy; and watchful waiting for older men and those suffering from other illnesses and whose cancer is causing no symptoms. Surgery and radiation therapy may still be used at this stage but there is a possibility that they might not work.
Stage IV cancers, or those that have spread to the bladder, rectum, lymph nodes, bones and other distant organs, are generally considered as non-curable. Treatment options can still be used, though, and they can include hormone therapy; external beam radiation plus hormone therapy; surgery; watchful waiting for older men; and chemotherapy.
Prostate treatments for cancer vary depending on the cancer's stage. For patients to better understand the benefits and possible side effects of these treatment options, a thorough discussion with the doctor is necessary.
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