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.

Diagram showing locally advanced prostate cancer

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
Locally advanced prostate cancer can have a CPG of 4 or 5.

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


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
  • Prostate cancer: diagnosis and management
    National Institute for Health and Care Excellence (NICE), 2019. Last updated December 2021

  • The Cambridge Prognostic Groups for improved prediction of disease mortality at diagnosis in primary non-metastatic prostate cancer: a validation study
    V J Gnanapragasam and others
    BMC Medicine, 2018. Vol 16, Issue 31

  • Risk stratification for prostate cancer management: value of the Cambridge Prognostic Group classification for assessing treatment allocation
    M G Parry and others
    BMC Medicine, 2020. Vol 18, Issue 114

  • ¬†

    AJCC Cancer Staging Manual (8th Edition)
    American Joint Committee on Cancer, 2017


  • Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow up
    C Parker and others
    Annals of Oncology, 2020. Vol 31, Issue 9. Pages 1119-1134

Last reviewed: 
31 May 2022
Next review due: 
31 May 2025