STAGES OF PROSTATE CANCER
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
  	
  	
  	
  	
  (512)	
  324-­‐8060	
  www.austincyberknife.com
A	
  prostate	
  cancer	
  diagnosis	
  can	
  be	
  scary.	
  
	
  
Learn	
  more	
  about	
  prostate	
  cancer	
  and	
  how	
  we	
  can	
  help.	
  
	
  
Please	
  note:	
  The	
  informa1on	
  presented	
  here	
  is	
  not	
  all-­‐inclusive.	
  Rather,	
  it	
  represents	
  a	
  star1ng	
  
point	
  to	
  learn	
  more	
  about	
  medical	
  condi1ons	
  and	
  treatment	
  op1ons.	
  There	
  is	
  no	
  subs,tute	
  for	
  
consul,ng	
  a	
  medical	
  professional.	
  
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Prostate Cancer Overview
Possible Signs of Prostate Cancer:
Weak or interrupted flow of urine
Frequent urination
Trouble urinating
Pain or burning during urination
Blood in the urine or semen
Persistent pain in the back, hips, or pelvis
Painful ejaculation
¨  The prostate is a
walnut-sized gland
located in a man’s
lower abdomen that
controls the flow of
urine and semen.
¨  Prostate cancer is a
leading cause of
cancer death among
American men, second
only to lung cancer.
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Diagnosing Prostate Cancer
Prostate cancer can be diagnosed by:
¨  Digital Rectal Exam (DRE) – examination of
the rectum.
¨  Prostate-specific antigen (PSA) test –
measures the level of PSA in the blood. PSA
may be found in an increased amount in the
blood of men with prostate cancer.
¨  Transrectal Ultrasound – provides a picture of
the prostate for the doctor to analyze.
¨  Gleason Score – determines how likely
prostate cancer is to spread.
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
The TNM Staging System
A staging system describes how far a cancer has spread.
The most widely used staging system for prostate cancer is
the American Joint Committee on Cancer (AJCC) TNM
system.
The TNM system for prostate cancer is based on 5 key
pieces of information:
¤  The extent of the primary tumor (T category)
¤  Whether the cancer has spread to nearby lymph nodes (N
category)
¤  The absence or presence of distant metastasis (M category)
¤  The PSA level at the time of diagnosis
¤  The Gleason Score, based on the prostate biopsy (or surgery)
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Prostate Cancer - Stage I
¨  Cancer is found in the prostate only.
¨  Cancer is microscopic and cannot be felt during the
DRE or seen on imaging tests.
¨  Cancer is found in one-half or less of one lobe of
the prostate.
¨  PSA level is lower than 10 ng/mL.
¨  Gleason Score is 6 or lower.
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Prostate Cancer - Stage IIA
¨  Cancer is more advanced than
Stage I but has not spread outside
the prostate.
¨  The cells are usually more
abnormal and may tend to grow
more quickly.
¨  Cancer is found in more than half
of one lobe of the prostate.
¨  PSA level is lower than 20 ng/mL.
¨  Gleason Score is 7 or lower.
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Prostate Cancer - Stage IIB
¨  Cancer is found in opposite sides of the prostate.
¨  Cancer cannot be felt during a DRE and is not
visible by imaging.
¨  The tumor has not spread outside the prostate.
¨  PSA level is 20 ng/mL or higher.
¨  Gleason Score ranges from 2 to 10.
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Prostate Cancer - Stage III
¨  Cancer has spread beyond the
outer layer of the prostate.
¨  Cancer may have spread to
nearby tissues like the seminal
vesicles.
¨  PSA can be any level.
¨  Gleason Score can range from
2 to 10.
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Prostate Cancer - Stage IV
¨  Cancer has spread
(metastasized) beyond the
seminal vesicles to nearby
tissues or organs such as
the rectum, bladder or
pelvic wall.
¨  Cancer has spread to
distant parts of the body,
which may include other
lymph nodes or bones.
Prostate cancer often
spreads to the bones.
¨  Cancer has spread to
nearby lymph nodes
¨  PSA can be any level.
¨  Gleason score can range
from 2 to 10.
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Prostate Cancer Treatment
Treatment Options
Active Surveillance
Surgery
External-Beam Radiation Therapy
Brachytherapy
Proton Therapy
Stereotactic Body Radiation Therapy
¨  Treatment options depend on:
¤  The stage of the cancer
¤  The patient’s age and health
¤  The patient’s Gleason Score
¤  Whether the cancer is recently
diagnosed or recurring
¤  The patient’s prostate-specific
antigen (PSA) levels
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
CyberKnife® Treatment Process
¨  Prior to stereotactic body radiation therapy with CyberKnife, small
tissue markers known as fiducials are implanted in the prostate to
help pinpoint the tumor location throughout each treatment.
¨  About a week later, patients undergo pretreatment imaging,
including CT scans which are used by physicians in the treatments
planning process.
¨  This treatment process
includes
¤  Consultation appointment
¤  Pretreatment procedures
¤  CyberKnife treatment
¤  Follow-up
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Additional Resources
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Austin CyberKnife was the first in the greater Austin area, as well as
the central Texas region, to offer CyberKnife treatment, giving our
physicians the most experience treating patients with this technology in
our area. Austin CyberKnife is a department of University Medical
Center Brackenridge, a member of the Seton Healthcare Family.
If you or a loved one is diagnosed with prostate cancer, contact Austin
CyberKnife to schedule a consultation with our physicians to determine
the best next step for your treatment needs.
Medical Director: Dr. Doug Rivera
CyberKnife Nurse: Lori Eitelbach, RN
Medical Physicist: Jim Hevezi, PhD
Our Center
1400	
  North	
  IH	
  35,	
  Austin,	
  TX	
  78701 	
   	
  (512)	
  324-­‐8060 	
  www.austincyberknife.com	
  
Connect	
  With	
  Us	
  

Stages of Prostate Cancer

  • 1.
    STAGES OF PROSTATECANCER 1400  North  IH  35,  Austin,  TX  78701          (512)  324-­‐8060  www.austincyberknife.com
  • 2.
    A  prostate  cancer  diagnosis  can  be  scary.     Learn  more  about  prostate  cancer  and  how  we  can  help.     Please  note:  The  informa1on  presented  here  is  not  all-­‐inclusive.  Rather,  it  represents  a  star1ng   point  to  learn  more  about  medical  condi1ons  and  treatment  op1ons.  There  is  no  subs,tute  for   consul,ng  a  medical  professional.   1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 3.
    Prostate Cancer Overview PossibleSigns of Prostate Cancer: Weak or interrupted flow of urine Frequent urination Trouble urinating Pain or burning during urination Blood in the urine or semen Persistent pain in the back, hips, or pelvis Painful ejaculation ¨  The prostate is a walnut-sized gland located in a man’s lower abdomen that controls the flow of urine and semen. ¨  Prostate cancer is a leading cause of cancer death among American men, second only to lung cancer. 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 4.
    Diagnosing Prostate Cancer Prostatecancer can be diagnosed by: ¨  Digital Rectal Exam (DRE) – examination of the rectum. ¨  Prostate-specific antigen (PSA) test – measures the level of PSA in the blood. PSA may be found in an increased amount in the blood of men with prostate cancer. ¨  Transrectal Ultrasound – provides a picture of the prostate for the doctor to analyze. ¨  Gleason Score – determines how likely prostate cancer is to spread. 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 5.
    The TNM StagingSystem A staging system describes how far a cancer has spread. The most widely used staging system for prostate cancer is the American Joint Committee on Cancer (AJCC) TNM system. The TNM system for prostate cancer is based on 5 key pieces of information: ¤  The extent of the primary tumor (T category) ¤  Whether the cancer has spread to nearby lymph nodes (N category) ¤  The absence or presence of distant metastasis (M category) ¤  The PSA level at the time of diagnosis ¤  The Gleason Score, based on the prostate biopsy (or surgery) 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 6.
    Prostate Cancer -Stage I ¨  Cancer is found in the prostate only. ¨  Cancer is microscopic and cannot be felt during the DRE or seen on imaging tests. ¨  Cancer is found in one-half or less of one lobe of the prostate. ¨  PSA level is lower than 10 ng/mL. ¨  Gleason Score is 6 or lower. 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 7.
    Prostate Cancer -Stage IIA ¨  Cancer is more advanced than Stage I but has not spread outside the prostate. ¨  The cells are usually more abnormal and may tend to grow more quickly. ¨  Cancer is found in more than half of one lobe of the prostate. ¨  PSA level is lower than 20 ng/mL. ¨  Gleason Score is 7 or lower. 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 8.
    Prostate Cancer -Stage IIB ¨  Cancer is found in opposite sides of the prostate. ¨  Cancer cannot be felt during a DRE and is not visible by imaging. ¨  The tumor has not spread outside the prostate. ¨  PSA level is 20 ng/mL or higher. ¨  Gleason Score ranges from 2 to 10. 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 9.
    Prostate Cancer -Stage III ¨  Cancer has spread beyond the outer layer of the prostate. ¨  Cancer may have spread to nearby tissues like the seminal vesicles. ¨  PSA can be any level. ¨  Gleason Score can range from 2 to 10. 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 10.
    Prostate Cancer -Stage IV ¨  Cancer has spread (metastasized) beyond the seminal vesicles to nearby tissues or organs such as the rectum, bladder or pelvic wall. ¨  Cancer has spread to distant parts of the body, which may include other lymph nodes or bones. Prostate cancer often spreads to the bones. ¨  Cancer has spread to nearby lymph nodes ¨  PSA can be any level. ¨  Gleason score can range from 2 to 10. 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 11.
    Prostate Cancer Treatment TreatmentOptions Active Surveillance Surgery External-Beam Radiation Therapy Brachytherapy Proton Therapy Stereotactic Body Radiation Therapy ¨  Treatment options depend on: ¤  The stage of the cancer ¤  The patient’s age and health ¤  The patient’s Gleason Score ¤  Whether the cancer is recently diagnosed or recurring ¤  The patient’s prostate-specific antigen (PSA) levels 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 12.
    CyberKnife® Treatment Process ¨ Prior to stereotactic body radiation therapy with CyberKnife, small tissue markers known as fiducials are implanted in the prostate to help pinpoint the tumor location throughout each treatment. ¨  About a week later, patients undergo pretreatment imaging, including CT scans which are used by physicians in the treatments planning process. ¨  This treatment process includes ¤  Consultation appointment ¤  Pretreatment procedures ¤  CyberKnife treatment ¤  Follow-up 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 13.
    Additional Resources 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com  
  • 14.
    Austin CyberKnife wasthe first in the greater Austin area, as well as the central Texas region, to offer CyberKnife treatment, giving our physicians the most experience treating patients with this technology in our area. Austin CyberKnife is a department of University Medical Center Brackenridge, a member of the Seton Healthcare Family. If you or a loved one is diagnosed with prostate cancer, contact Austin CyberKnife to schedule a consultation with our physicians to determine the best next step for your treatment needs. Medical Director: Dr. Doug Rivera CyberKnife Nurse: Lori Eitelbach, RN Medical Physicist: Jim Hevezi, PhD Our Center 1400  North  IH  35,  Austin,  TX  78701    (512)  324-­‐8060  www.austincyberknife.com   Connect  With  Us