Every stage of prostate cancer stage requires different treatment approaches. Dr. Alicia Morgans explains prostate cancer staging and how it impacts treat options.
Dr. Alicia Morgans is an Assistant Professor of Medicine at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.
Dr. Alicia Morgans:
Staging in prostate cancer is a way for people to understand how to best approach the treatment of the disease. To say this a different way, low stages – things like Stage I, II, and usually Stage III – can be treated with local therapies to the prostate itself with a goal of trying to cure the prostate cancer. And some patients who have Stage I disease may not even need active treatment, but could be followed on active surveillance as a way to monitor the cancer and prevent side-effects by simply monitoring until it would actually need treatment. Higher stage, like Stage IV, means that the cancer has spread outside of the prostate.
And it’s still prostate cancer. It just is cancer cells from the prostate that now live in the bones, or live in distant lymph nodes, or live in another organ or place in the body. Those cancer cells are still treated the exact same way we treat prostate cancer in terms of the medical therapies – the injections, the pills, the chemo agents potentially – that we would use to treat those cancer cells, whether they’re in the bones or in the prostate. But when they have spread outside of prostate, that typically means that there’s no longer an opportunity for us to cure that cancer. And we wouldn’t necessarily use things like surgery or radiation to the prostate if the cancer had spread.
I say “wouldn’t necessarily,” because that is certainly an area that’s evolving. And now even men with metastatic prostate cancer or Stage IV prostate cancer can be treated with radiation, in particular, to the prostate, and we know that can be beneficial. So, staging helps us understand how far the cancer has spread or not spread.
And it helps us understand if we can treat that patient with local treatments to the prostate to try to cure them, or if we need to use medical therapies as a major backbone of treatment rather than things like radiation or surgery to treat them for prolonging their life and improving quality of life but knowing that we can’t cure their disease.