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Prostate Cancer: Treatments by Stage
Understanding the size, location, and amount of spreading of the prostate cancer (metastasis) is important. These factors are evaluated and given a staging letter, number, or grouping. Staging is one of the most important factors in deciding the best way to treat prostate cancer.
Your medical team will consider other factors, too, such as age, life expectancy, and risk of recurrence after treatment based on Gleason scores and PSA levels.
Stage I. These prostate cancers are small and have low Gleason scores. They usually grow very slowly and may never cause any symptoms or other health problems.
For men without any prostate cancer symptoms who are elderly and/or have other serious health problems, watchful waiting and radiation therapy (external beam or brachytherapy) are reasonable options.
Men who are younger and healthy may consider watchful waiting, surgery to remove the prostate (radical prostatectomy), or radiation therapy (external beam or brachytherapy).
Stage II. Compared with stage I prostate cancers, stage II cancers that are not treated with surgery or radiation are more likely to spread beyond the prostate and cause symptoms.
As with stage I cancers, watchful waiting by following PSA levels is often a good option for men whose cancer is not causing any symptoms and who are elderly and/or have other serious health problems. Radical prostatectomy and radiation therapy (external beam or brachytherapy) may also be appropriate options.
Treatment options for men who are younger and otherwise healthy include:
- Radical prostatectomy (often with removal of the pelvic lymph nodes; sometimes preceded by hormone therapy
- External beam radiation only*
- Brachytherapy only*
- Brachytherapy and external beam radiation combined*
- Cryosurgery (surgery that freezes diseased tissue. Compared with surgery or radiation therapy, much less is known about the long-term effectiveness of cryosurgery).
* All radiation options may also have three to six months of hormone therapy.
Stage III. Stage III cancers have spread beyond the prostate gland but have not reached the bladder, rectum, lymph nodes, or distant organs. Surgery and radiation therapy may be less likely to work but may still be options.
Possible treatment options at this stage:
- External beam radiation plus hormone therapy
- Hormone therapy only
- Radical prostatectomy in selected cases. This is not nerve sparing (often with removal of the pelvic lymph nodes; sometimes preceded by hormone therapy)
- Watchful waiting for older men whose cancer is causing no symptoms or for those who have another more serious illness
Stage IV. Stage IV cancers have already spread to the bladder, rectum, lymph nodes, or distant organs such as the bones. Doctors don't usually consider these cancers to be curable.
Treatment options may include:
- Hormone therapy
- External beam radiation plus hormone therapy (in selected cases)
- Surgery (TURP) to relieve symptoms such as bleeding or urinary obstruction
- Watchful waiting for older men whose cancer is causing no symptoms or for those who have another serious illness
WebMD Medical Reference provided in collaboration with the Cleveland Clinic
Prostate Cancer Guide
Indication
Uroxatral® (alfuzosin HCl 10 mg extended-release tablets) is an alpha1-blocker for the treatment of the signs and symptoms of BPH.
Important Safety Information
Do not take UROXATRAL if you have liver problems or if you are taking antifungal drugs like ketoconazole or itraconazole, or HIV drugs like ritonavir.
UROXATRAL can cause a sudden drop in blood pressure, especially when starting treatment. This may lead to fainting, dizziness, and lightheadedness. Do not drive, operate machinery, or do any dangerous activity until you know how UROXATRAL will affect you. This is especially important if you already have a problem with low blood pressure or take medicines to treat high blood pressure. There may be an increased risk of low blood pressure and fainting when taking UROXATRAL in combination with blood pressure medication or nitrates, or erectile dysfunction medication.
If considering cataract surgery (clouding of the eyes), tell your eye surgeon that you are currently taking UROXATRAL or have previously been treated with an alpha-blocker.
Before taking UROXATRAL, tell your doctor if you have kidney problems.
Also, tell your doctor if you or any family member(s) have or take medications for a rare heart condition known as congenital prolongation of the QT interval.
BPH and prostate cancer can cause the same symptoms. However, UROXATRAL is not a treatment for prostate cancer.
The most common side effects with UROXATRAL are dizziness, upper respiratory tract infection, headache, and tiredness.
Please see UROXATRAL full prescribing information.
