Early Stage Prostate Cancer

Early stage or localized prostate cancer refers to cancer that is still confined to the prostate. Learn more and find questions to ask your doctor so you understand your diagnosis and treatment options.


EARLY STAGE PROSTATE CANCER Early stage prostate cancer refers to cancer that is still confined to the prostate. It is also called localized prostate cancer. If you have been diagnosed with early stage prostate cancer you will be able to choose which kind of treatment is best for you. And while it is good to have choices, this may not be an easy decision to make. Each treatment option available for men with early stage prostate cancer has benefits, risks, and unique side effects to consider. Understanding Early Stage Prostate Cancer Following your biopsy and diagnosis, you will work with your doctor(s) to gather information and learn about your disease and choices for treatment. Most prostate cancer is slow growing and may never cause any problems or symptoms. • Stage I means the cancer is small and only in the prostate • Stage II means the cancer is larger and may be in both lobes of the prostate, but is still confined to the prostate Other factors will help your doctor have a better picture of your cancer and make the best treatment recommendation for you. Make sure you know your results for the following: • PSA level

QUESTIONS for Your Doctor

• What is my Gleason Score, Grade Group, PSA level, and tumor stage? • Do I have low risk, intermediate risk, or high risk prostate cancer? • Should I have genetic and genomic (biomarker) testing done? Use ZERO’s Newly Diagnosed Worksheet to record this information.

• Digital Rectal Exam (DRE) • Gleason Score/Grade Group • Stage

This information determines your risk group: low, medium/intermediate, or high risk. It is believed that in more than half of men newly diagnosed with low risk prostate cancer, the cancer will not spread to other parts of the body. Genomic Testing There are several new genomic tests that go beyond the standard risk assessment done with a PSA test, Gleason Score, and DRE. These tests may be helpful if you have low risk prostate cancer because you might be a good candidate for Active Surveillance. If you have high risk prostate cancer, you will most likely have a more aggressive course of treatment because you are at higher risk for the disease to spread outside the prostate. Genomic testing looks at the genetic markers of the cancer cells to show how the cancer may behave. This allows doctors to provide a more personalized risk assessment when suggesting treatment options. Talk to your doctor about genomic testing before making a treatment decision.

Many people seek second opinions to explore all options. Seeking a second opinion is common and doing so can make you feel more confident in the treatment decision that you make. CONSIDER A SECOND OPINION?

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Treatment Options for Early Stage Prostate Cancer Treatment for early stage prostate cancer is done with the aim to cure the cancer. It is important to research your treatment options to make the right decision for you.

Some prostate cancer treatments may impact your sexual function so it is important to be open and honest with your partner. Ask your doctor questions and try to talk to other men who have been diagnosed with prostate cancer. The most common treatment options for early stage prostate cancer include: • Active surveillance – close monitoring of the status of your prostate cancer through regular office visits and repeat medical tests, such as the PSA test, imaging, or prostate biopsies • Surgery – a radical prostatectomy is the removal of the entire prostate by a surgeon • Radiation therapy – the use of radiation to destroy the cancer cells in the prostate

Before making a treatment decision, learn more about possible side effects: zerocancer.org/ side-effects

Other treatment options for early stage prostate cancer include: • Cryotherapy – freezing of the tumor to destroy the cancer cells • HIFU (high intensity focused ultrasound) – uses heat to kill the prostate cancer cells • Hormone Therapy – also known as androgen deprivation therapy or ADT, it stops or slows the body’s ability to make testosterone, aiming to stop tumor growth and/or shrink the tumor. It has always been an important treatment for advanced prostate cancer, and is sometimes used in combination with radiation therapy for early stage patients The treatments for early stage prostate cancer can cause significant, life impacting side effects. The most common side effects are erectile dysfunction (loss of erections) and urinary incontinence (leaking urine). It is important to talk with your doctor to understand potential side effects of each treatment option available to you and how these side effects can be addressed. Your treatment options will depend on many factors, most importantly the characteristics of your cancer, including stage, grade, and risk category. Other factors that are unique to you include: • Other health problems, such as heart disease, diabetes, or other chronic conditions • Previous prostate surgery • Age • Your personal preferences Before making treatment decisions, consider having a consultation with a medical oncologist, particularly if you have high risk disease. While your treatment will most likely be managed by a urologist or radiation oncologist, meeting with a medical oncologist will help you to have a full picture of all treatment options available to you. This is especially important should your cancer return at some point in the future. LEARN MORE We encourage you to use this information in conversations with your healthcare team about prostate cancer and related topics. For more information about prostate cancer and ZERO Prostate Cancer, visit our website zerocancer.org/learn . ZERO Prostate Cancer provides this information as a service. It is not intended to take the place of medical professionals or the recommendations of your healthcare team. We strongly suggest consulting your healthcare team if you have questions about your specific care.

© 2023 ZERO ® Prostate Cancer 04/23


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