Advanced Prostate Cancer, Prostate Cancer Library

This topic review will discuss the treatment of men with advanced prostate cancer. A separate topic review is available about the treatment of early stage prostate cancer. (See "Patient information: Early prostate cancer treatment"). STAGING OF PROSTATE CANCER — Treatment for prostate cancer depends upon its "stage", which indicates how far the cancer has spread within the body. Prostate cancer is usually staged according to the system known as TNM (tumor, node, metastasis), in which the cancer is characterized by its extent within the prostate gland itself (tumor or T stage), whether the lymph nodes in the region are involved with cancer (node or N stage), and whether the cancer has metastasized to other parts of the body (metastasis or M stage, show table 1). A full discussion of the diagnosis and staging of prostate cancer is available separately. (See "Patient information: Prostate cancer diagnosis and staging"). Various combinations of T, N, and M stage are grouped together to form stage groupings, from I to IV, which designate whether the cancer is considered localized (stage I and II), locally advanced (stage III), or metastatic (stage IV) (show table 2). T3 and T4 tumors that lack involvement of lymph nodes or distant organs are considered locally advanced, meaning that although the cancer is outside of the prostate gland, it has not extended beyond the tissues adjacent to the original tumor. On the other hand, metastatic (stage IV) prostate cancer has spread beyond the prostate to either the lymph nodes or to other organs or the bone