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Prostate Cancer: Treatments by Stage

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Once your doctor determines the stage of your prostate cancer, he can start mapping out a treatment plan. Stage is based on:

  • The size of your tumor
  • How far it has spread
  • The chances of it coming back

Matching the right treatment with your stage isn’t always cut and dry. You might benefit from a combo of a few different approaches. Together, you and your doctor will decide on the best treatment.

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There are three different doctors who might be involved in your care:

Here are the stages of prostate cancer along with common treatment options.

Stage I

The cancer is small, and it hasn't grown outside your prostate. Slow-growing cancers might never cause symptoms or other health problems.

In this stage, your PSA levels and Gleason scores are low, and that's good. When they're higher, your cancer is more aggressive. It’s also more likely to come back and require more intensive treatment.

The PSA (prostate-specific antigen) test measures levels of this protein in your blood. Your doctor then determines your Gleason score by looking at prostate tissue cells under a microscope.

With stage I, you should consider the following treatment approaches:

  • Active surveillance. Your doctor tracks your PSA levels. If those levels rise, it might mean your cancer is growing or spreading. Your doctor can then change your treatment. He might also do tests like rectal exams and ultrasounds.
  • Watchful waiting. This involves fewer tests than active surveillance. Your doctor keeps a close watch on your symptoms. If you're an older man, or you have other serious health problems, your doctor might opt for this method.
  • Radiation therapy. This kills prostate cancer cells or keeps them from growing and dividing. There are two types of this treatment. The "external" kind uses a machine to aim a beam of radiation at your tumor. With "internal radiation," a doctor places radioactive pellets or seeds in or next to the tumor -- this procedure is also known as brachytherapy.
  • Ablation therapy. This treatment uses freezing or high-intensity ultrasound to kill cancer cells.
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