After a cancer diagnosis, staging of the cancer takes place. Staging involves classifying cancer in a standardized way, according to the spread of disease and diagnostic markers. The stage of disease helps guide treatment plans as well as tentative prognosis. Prostate cancer is staged anywhere from Stage I, the least invasive disease, to Stage IV, which is metastatic disease that has reached distant organs.
Symptoms
Symptoms of prostate cancer can vary, and not every man has symptoms; some cancers are found on exam by a health care provider. When they do occur, the Prostate Cancer Foundation lists common symptoms as including frequent urges to urinate, interrupted or weak urine flow, difficulties with erections, painful ejaculation and blood in urine or semen.
Stage IIA
Stage IIA prostate cancer can be diagnosed in a variety of situations. The first situation, according to the American Cancer Society, is when the cancer is unable to be felt on exam or seen on a transrectal ultrasound, but was diagnosed by a needle biopsy or a transurethral resection. There is no cancer in the lymph nodes or in distant organs in the body, the Gleason score is 7, and the PSA is less than 20. The next possible diagnostic scenario includes the same situation, but with a Gleason score of 6 or less and a PSA that ranges from 10 to 20. The last possible diagnostic situation for Stage IIA prostate cancer includes a tumor that is felt during a digital rectal exam or seen on an ultrasound, but is only on a single side of the prostate. No cancer is in distant organs or lymph nodes, and the Gleason score is 7 or less, and the PSA is less than 20.
Stage IIB
Stage IIB prostate cancer can also be diagnosed in three situations. The first possible diagnosis can be made when the tumor is felt on rectal exam or seen on transrectal ultrasound and is on both sides of the prostate, according to the American Cancer Society. It has not spread to the lymph nodes or any distant organs, and can have any Gleason score or PSA. This stage may also be diagnosed when the cancer has not spread outside the prostate and may or may not be found on digital exam or ultrasound. The cancer is not in lymph nodes or other organs, but the PSA is at least 20, with any Gleason score. The last situation this stage may be diagnosed at includes the same situation as the last, but the Gleason score is 8 or more, with a PSA of any value.
Treatment
The National Cancer Institute lists several treatments for Stage II prostate cancer. A radical prostatectomy with lymph node removal may be done, which involves removal of the whole prostate. Radiation therapy may be given post-surgery. Radiation therapy may be done, either internally with radioactive implants, or externally via a machine; this may be done with or without hormone therapy for the cancer. Watchful waiting may be an option for those with slow-growing cancer, and clinical trials may be an option for some patients.
Prognosis
According to the National Cancer Institute, the prognosis for prostate cancer depends not only on the stage of the cancer, but the individual's overall health, the Gleason score and PSA value, and whether the cancer has recurred or not. The American Cancer Society lists the five-year survival rate, or the percentage of patients alive five years post-diagnosis, for local (confined to the prostate) and regional (tissues around the prostate) prostate cancer as 100 percent.
