A comprehensive approach in every phase

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• The cancer is small and confined to the prostate gland.
• It cannot be felt during a digital rectal exam (DRE).
• It is usually found accidentally during a biopsy for another reason (e.g., an elevated PSA test).
• The PSA level is low, usually below 10 ng/mL..
• The Gleason score (which indicates how abnormal cancer cells look under a microscope) is 6 or lower, meaning it is a slow-growing cancer.

 No spread to nearby lymph nodes or distant organs 

•  Often no symptoms, which is why early screening is crucial.
• Some men may experience mild urinary changes, but they are typically attributed to benign prostate enlargement.

1) Active surveillance (monitoring without immediate treatment).

2) Radical prostatectomy (surgical removal of the prostate) for younger patients.

3) Radiation therapy for those preferring a non-surgical approach.

• The tumor is larger than Stage I, but still inside the prostate gland.
• It may be felt during a DRE if it is on the outer edges of the prostate.
• The PSA level is moderately elevated, typically between 10-20 ng/mL.
• The Gleason score is 6 to 7, indicating slightly more aggressive cancer than Stage I.

No spread to nearby tissues, lymph nodes, or distant organs.

Some men may start experiencing urinary symptoms such as:

• Weak urine stream.
• Increased frequency of urination, especially at night.
• Trouble starting and stopping urination.

1) Active surveillance for slow-growing cases.

2) Radiation therapy (external beam or brachytherapy).

3) Surgery (radical prostatectomy) if the patient is in good health and eligible for surgery.

• Cancer has grown outside the prostate capsule, meaning it is no longer confined.
• It may have reached the seminal vesicles, which are glands that produce part of the semen.
• The PSA  level is usually higher than 20 ng/mL.
• The Gleason score is 7-8, meaning the cancer cells look more abnormal and may  grow faster.

Cancer has spread beyond the prostate, often to:

• The seminal vesicles (Stage IIIA).
• The bladder or rectum (Stage IIIB).
• It may have reached nearby lymph nodes (Stage IIIC).

Distant spread (metastasis) is not present yet.

More noticeable urinary problems, including:

• Difficulty urinating.
• Frequent urination, including at night.
• Blood in urine or semen.

Pelvic pain or discomfort due to cancer spreading to surrounding tissues.

Some men may experience erectile dysfunction.

1) Radiation therapy with hormone therapy (hormonal treatment lowers testosterone, which fuels prostate cancer growth).

2) Surgery (radical prostatectomy) combined with radiation for aggressive cases.

3) Androgen Deprivation Therapy (ADT) for patients who are not candidates for surgery or radiation.

• The cancer has spread beyond the prostate to distant lymph nodes, bones, or other organs (lungs, liver, etc.).
• The PSA level is often very high, frequently exceeding 50-100 ng/mL.
• The Gleason score is 8-10, meaning the cancer is highly aggressive.

Cancer has spread to:

• Nearby tissues and lymph nodes (Stage IVA).
• Bones, lungs, liver, or other organs (Stage IVB).

The most common metastatic site for prostate cancer is the bones, leading to:

• Bone pain.
• Fractures.
• Spinal cord compression, which can cause paralysis in severe cases.

• Severe urinary issues or complete inability to urinate.
• Chronic pain, especially in the lower back, pelvis, or ribs due to bone metastases.
• Unintended weight loss and fatigue.
• Swelling in legs (caused by lymph node obstruction).
• Breathing difficulties (if the cancer has spread to the lungs).

1) Hormone Therapy (Androgen Deprivation Therapy – ADT): Slows cancer growth by reducing testosterone.

2) Chemotherapy: Often used when ADT is no longer effective.

3) Targeted Therapy & Immunotherapy: Newer treatments that attack specific cancer cells.

4) Bone-Strengthening Medications: Help reduce bone pain and fractures in patients with bone metastases.

5) Radiation Therapy: Helps relieve symptoms in advanced cases..