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Prostate cancer

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Treatment of stage II prostate cancer

The following are treatment options for stage II prostate cancer. The types of treatments given are based on the unique needs of the person with cancer.

Surgery

Surgery may be offered for stage II prostate cancer. The types of surgery are:

  • radical prostatectomy – may be offered to men younger than 75 years of age who are in good health
  • pelvic lymph node dissection – is combined with radical prostatectomy in men with intermediate-risk or high-risk prostate cancer
  • cryosurgery and HIFU may be options for some men offered in a few treatment centres
    • Cryosurgery is a surgical procedure that uses extremely cold or freezing temperatures to destroy abnormal cells or tissue.
    • High intensity focused ultrasound (HIFU) uses focussed ultrasound waves to create intense heat, which destroys the cancer cells.

Radiation therapy

Radiation therapy may be offered for stage II prostate cancer. The types of radiation therapy are:

  • external beam radiation therapy
    • may be offered to men younger than 75 years of age who are in good health
    • given after surgery (adjuvant radiation) if the tumour spread is close to the edge of the area from where the prostate gland was removed
    • given if elevated PSA levels indicate the presence of residual cancer or a recurrence of the prostate cancer after radical prostatectomy
    • may be delayed 4–6 weeks if the prostate cancer was found during a transurethral resection of the prostate (TURP), to reduce the risk of scarring in the urethra (urethral stricture)
  • brachytherapy
    • may be offered to men who meet the criteria of the brachytherapy program:
      • early stage prostate cancer still within the prostate gland (T1c – T2a)
      • no larger than 60 cubic centimetres in volume
      • a Gleason score less than 7
      • a PSA level of 10 or less
      •  a life expectancy of at least 10 years
      • able to undergo general or spinal anesthesia
      • have not had a transurethral resection of the prostate (TURP)

Active surveillance

Active surveillance (watchful waiting) may be offered for stage II prostate cancer in certain situations. It may be offered to men with favourable (low) risk prostate cancer or to older men (over the age of 70) and men who have other health problems.

Hormonal therapy

Hormonal therapy may be offered for stage II prostate cancer to men who have intermediate-risk or high-risk prostate cancer that cannot be treated with radiation therapy or surgery.

Hormonal therapy drugs may be given before, during and after radiation therapy, for a period of 6 months to 3 years.

  • The types of hormonal therapy are:
  • luteinizing hormone–releasing hormone (LHRH) agonists
    • leuprolide (Lupron, Lupron Depot, Eligard)
    • goserelin (Zoladex)
    • buserelin (Suprefact)
  • LHRH antagonist
    • degarelix (Firmagon)
  • anti-androgens
    • flutamide (Euflex)
    • bicalutamide (Casodex)
    • nilutamide (Anandron)
  • surgical removal of the testicles (orchiectomy)

Clinical trials

Men with prostate cancer may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.

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