Locally advanced prostate cancer

Doctors may describe prostate cancer as localised, locally advanced and metastatic. Locally advanced prostate cancer means that the cancer has broken through the capsule (covering) of the prostate gland. It may have spread into the:

• tissue around the prostate
• the tubes that carry semen. These are the seminal vesicles
• body organs nearby such as the back passage or bladder
• lymph nodes close to the prostate gland

In the TNM staging system, locally advanced prostate cancer is the same as T3 or T4. Below is a simplified description of the T3 and T4 stage:

T3 means the cancer has broken through the capsule (covering) of the prostate gland.

T4 means the cancer has spread into other body organs nearby, such as the back passage, bladder, or the pelvic wall.

Prognostic groups for locally advanced prostate cancer

Doctors divide locally advanced prostate cancer into groups depending on how likely it is that the cancer will grow quickly or spread. In the UK, doctors now divide prostate cancer into 5 groups. This is the Cambridge Prognostic Group (CPG). The 5 groups are from CPG 1 to CPG 5. This CPG system does not apply if you have cancer that has already spread to other parts of the body. This is metastatic or advanced prostate cancer.

Your group depends on:

• your Grade Group or Gleason score
• the prostate specific antigen (PSA) level
• the size of your cancer. This is the T stage

Ask your doctor or specialist nurse if you have any questions about this.

Treatment

Treatment for locally advanced prostate cancer depends on your risk group. It also depends on a number of things such as:

• your age and general health
• how you feel about the treatments and side effects

Your doctor usually recommends you have treatment. Treatment might include:

• surgery to remove your prostate or
• external radiotherapy