Prostate cancer patients most commonly develop blockage to urine flow or blood in urine. However, people who perform a blood test called PSA on yearly basis may reach a diagnosis before the the cancer blocks the flow of urine. Prostate cancer spreads mainly to back bones and when this happens patients develop back pain.
Diagnosis is reached based on ultrasound and biopsy. Prostate specific antigen (PSA) in blood can give good idea about the aggressiveness of the disease. The planning of treatment depends on the features on biopsy and PSA levels, in addition to many other factors.

STAGING & TREATMENT OF PROSTATE CANCER

Stage I :

These cancers are contained inside prostate with good risk features. The treatment advisable is radical prostatectomy. Robotic or Laparoscopic Radical Prostatectomy is as effective as open surgery and is much better tolerated by the patients. Patients who are unfit for surgery may be given radiation or just observed with PSA levels.

Stage II :

This is a more aggressive tumor that needs to be treated more by either surgery (radical prostatectomy) or radiation. Robotic or Laparoscopic Radical Prostatectomy is as effective as open surgery and is much better tolerated by the patients. Radiation therapy is combined with hormone therapy for 3 to 6 months. Only in extremely unfit patients these may be observed with PSA monitoring.

Stage III :

Stage III cancers have spread just beyond the prostate gland. Surgery and radiation therapy are the options. Robotic or Laparoscopic Radical Prostatectomy is as effective as open surgery and is much better tolerated by the patients. It needs to be combined with hormone therapy after surgery.

Stage IV :

Stage IV cancers have already spread to adjacent organs (bladder, rectum) or to lymph nodes or to distant organs like bones. These are not curable. But, many of these patients do well with hormonal treatment.