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STAGES OF PROSTATE CANCER
6802 South Olympia Ave Suite G100, Tulsa, OK 74132 (918) 949-6676www.oklahomack.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.	
  
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.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.
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.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.
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.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)
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.com	
  
Prostate Cancer - Stage I
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.com	
  
¨  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.
Prostate Cancer - Stage IIA
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.com	
  
¨  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.
Prostate Cancer - Stage IIB
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.com	
  
¨  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.
Prostate Cancer - Stage III
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.com	
  
¨  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.
Prostate Cancer - Stage IV
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.com	
  
¨  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.
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
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.com	
  
CyberKnife® Treatment Process
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.com	
  
¨  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 are fitted with a custom body mold of
soft material that they lie on during treatments. The fitting process is
painless.
¨  This treatment process
includes
¤  Consultation appointment
¤  Pretreatment procedures
¤  CyberKnife treatment
¤  Follow-up
Additional Resources
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.com	
  
Our Center
Opened in 2008, Oklahoma CyberKnife is widely known as a leading
provider of stereotactic radiosurgery. Oklahoma CyberKnife is service of
Hillcrest Medical Center.
If you or a loved one is diagnosed with prostate cancer, contact Oklahoma
CyberKnife to schedule a consultation with our physicians to determine the best
next step for your treatment needs.
Medical Director: Dr. Diane Heaton
Radiation Oncologist: Dr. Joshua Garren
6802	
  South	
  Olympia	
  Ave	
  Suite	
  G100,	
  Tulsa,	
  OK	
  74132 	
   	
  (918)	
  949-­‐6676 	
   	
  www.oklahomack.com	
  
Connect	
  With	
  Us	
  

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Stages of Prostate Cancer

  • 1. STAGES OF PROSTATE CANCER 6802 South Olympia Ave Suite G100, Tulsa, OK 74132 (918) 949-6676www.oklahomack.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.   6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com  
  • 3. 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. 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com  
  • 4. 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. 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com  
  • 5. 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) 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com  
  • 6. Prostate Cancer - Stage I 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com   ¨  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.
  • 7. Prostate Cancer - Stage IIA 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com   ¨  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.
  • 8. Prostate Cancer - Stage IIB 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com   ¨  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.
  • 9. Prostate Cancer - Stage III 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com   ¨  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.
  • 10. Prostate Cancer - Stage IV 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com   ¨  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.
  • 11. 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 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com  
  • 12. CyberKnife® Treatment Process 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com   ¨  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 are fitted with a custom body mold of soft material that they lie on during treatments. The fitting process is painless. ¨  This treatment process includes ¤  Consultation appointment ¤  Pretreatment procedures ¤  CyberKnife treatment ¤  Follow-up
  • 13. Additional Resources 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com  
  • 14. Our Center Opened in 2008, Oklahoma CyberKnife is widely known as a leading provider of stereotactic radiosurgery. Oklahoma CyberKnife is service of Hillcrest Medical Center. If you or a loved one is diagnosed with prostate cancer, contact Oklahoma CyberKnife to schedule a consultation with our physicians to determine the best next step for your treatment needs. Medical Director: Dr. Diane Heaton Radiation Oncologist: Dr. Joshua Garren 6802  South  Olympia  Ave  Suite  G100,  Tulsa,  OK  74132    (918)  949-­‐6676    www.oklahomack.com   Connect  With  Us