Prostate Cancer Staging & Treatments

Best medical treatments for prostate cancer

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Accurate Cancer Staging and Personalized Treatment Options

Beth Israel Deaconess Medical Center (BIDMC) prostate specialists have decades of experience in carefully planning for and treating prostate cancer. The prostate cancer treatment plan is personalized for each man.

We offer specialized tools in decision-making that let us better understand what’s important to you. Then, we base our advice on your preferences.

Our multidisciplinary team — including urologists, medical oncologists and radiation oncologists — helps you make the best decision for your treatment. We individualize our recommendations based on your preferences, quality of life and details about your cancer.

Staging Prostate Cancer: Gleason Scale

Your prostate specialist will order a prostate biopsy (removal of tissue sample) to make an accurate diagnosis. Your doctor sends the tissue sample to the laboratory.

At the lab, a pathologist carefully checks the tissue for cancer cells. The pathologist also grades each sample on what is known as the Gleason scale to measure the cancer’s aggressiveness. The pathologist grades samples from 6 to 10:

Gleason score 6 (Grade Group 1) is a low-grade cancer
Gleason score 7 (Grade Groups 2-3) is intermediate
Gleason score 8-10 (Grade Groups 4-5) are more aggressive cancers

Thanks to prostate-specific antigen (PSA) tests, most cancers that specialists find today are in an early stage.

Hormonal Therapy

Specialists may recommend hormonal therapy for some men with prostate cancer. The goal of hormonal therapy is to block the production of or action of the male hormones that fuel prostate cancer.

Medical oncologists typically use multiple hormone blockers in combination. Some of the common types:

Casodex (bicalutamide)
Lupron (leuprolide acetate)

Orgovyx (relugolix)

For more advanced cancer that becomes resistant to hormonal therapy (or sometimes as part of earlier therapy), other treatments may be used including:

Radioligand therapy, e.g. Pluvicto
Other radiopharmaceuticals, e.g. Xofigo
Targeted therapies, e.g. PARP inhibitors

Chemotherapies, e.g. docetaxel or cabazitaxel
Novel therapies as part of clinical trials

More About Prostate Cancer Staging & Treatments

Early-Stage Prostate Cancer

Men with early-stage prostate cancer have many treatment options. The treatment that’s best for one man may not be the best for another. The treatment that’s right for you depends on these main factors:

Your age
Grade of the tumor (Gleason score)
Number of biopsy tissue samples that contain cancer cells

Stage of the cancer
Your symptoms
Your overall health

You may receive a combination of approaches:

Active surveillance
Brachytherapy (seed implants)
CyberKnife stereotactic radiosurgery or other external radiation therapy approaches, with or without hormonal therapy

High Intensity Focused Ultrasound
Robot-assisted prostatectomy (removal of prostate gland)

Your doctor will describe your treatment choices, the expected results of each and the possible side effects. You and your doctor will work together to develop a treatment plan that meets your medical and personal needs. You may want to talk to your doctor about taking part in a clinical trial, a research study of new treatment methods.

Quality of Life

Treatment for early-stage prostate cancer is highly effective. In some cases, it can be associated with temporary or long-term side effects related to urinary, sexual or bowel and rectal concerns. These side effects vary with age and type of treatment. Post-treatment care, when needed, may include urinary and sexual rehabilitation services.

Aggressive Prostate Cancer

If your doctor considers your cancer to be high risk, you may have a bone scan, CT scan or MRI scan. Your doctor uses the results of these imaging tests to check if the cancer has spread beyond the prostate.

If the cancer has spread to other parts of the body, it cannot be cured. Treatment focuses on medicines that travel through the whole body to control the cancer. Treatments aimed only at the prostate may still help in some cases, but they usually cannot remove the cancer completely.

Advanced-Stage Prostate Cancer

In most cases, the prostate cancer team will suggest some combination of these treatments:

The goal of these treatments is to extend life and prevent or relieve symptoms, rather than to cure the disease.

Quality of Life

We track our treatment outcomes for every patient. We are happy to share these details with you. We believe you deserve straightforward information about success rates at BIDMC and the impact treatment could have on your quality of life.

With our supportive care services, your prostate care team remains engaged in your care after treatment. We can help address ongoing side effects of treatment with services such as urinary and sexual rehabilitation.