Current issues in the treatment of locally advanced prostate cancer

Last reviewed: June 2004

For general information about CancerBACUP’s Controversial topics please see the introductory page.

This statement explores some of the issues involved in the treatment of early prostate cancer. The management of this disease is the subject of much controversy and continued debate. This is partly due to difficulties in accurate staging of the disease and partly due to the small amount of randomised trials. These controversies are not limited to the UK but are worldwide.

So far only a small number of randomised trials have looked at whether survival for men with early prostate cancer is increased by active intervention with radical prostatectomy, radiation or hormonal therapy (Holmberg et al., 2002). Treatment decisions must be made on an individual basis. Various factors such as the stage and grade of tumour, PSA levels, age, performance status, general health and the personal choices and values of the patient are taken into account.

Stage and grade of the tumour play a large part in decision making. The main staging system used in the UK is the TNM system and the Gleason score is universally used as the best system to grade the histology of the tumour.

Early disease is considered to be Stage T1-T2 (confined to the prostate), N0, M0.

For information on the management of early and metastatic prostate cancers, please refer to CancerBACUP’s additional Clinical Advisory Board statements.