Stage 1 Prostate Cancer Treatment


The stage of prostate cancer at diagnosis is typically determined by a staging system developed by the American Joint Committee on Cancer (AJCC) called the TNM System along with the Gleason score and the PSA level of the patient.


The TNM system evaluates the tumor based on the following criteria:

T Category
The extent of the primary prostate tumor
N Category
Whether or not the prostate cancer has spread to nearby lymph nodes
M Category
The absence or presence of distant metastasis

Gleason score

The Gleason score is a method of evaluating (from two to 10) how the prostate tumor appears under a microscope. The lower the Gleason score, the closer the tumor looks as compared to normal tissue. The higher the Gleason score, the more the tumor looks abnormal, which increases the likelihood that it will spread.

PSA levels

PSA (prostate-specific antigen) levels measure the amount that this specific protein is found in the blood. The higher the PSA level, the more likely prostate cancer is present.

Stage 1 Prostate Cancer

Prostate cancer that has been diagnosed as Stage 1 means is small in size (T1a-c, T2a, T1-2a), has not yet spread to lymph nodes (N0), has no indication of metastasis (M0), has a low Gleason score (less than or equal to six) and a low PSA level (less than 10). These prostate cancers typically are slow-growing and may not exhibit any signs and symptoms.

Typical treatment options for Stage 1 prostate cancer may include one or more of the following:

Watchful Waiting or Active Surveillance
This method, which consists of no active treatment, may be recommended for elderly men and/or those without major prostate cancer symptoms. Regular check-ups every three to six months that test the grade of the tumor and measure PSA levels typically are completed to get a sense about how fast the prostate cancer is growing and whether it is necessary to start other treatments.
The surgical removal of part or the entire prostate is an option for men who are diagnosed with Stage I prostate cancer. Surgical options include: open surgery, laparoscopic prostatectomy, robotic laparoscopic surgery, cryosurgery or transurethral resection of the prostate (TURP). During any of these surgeries, the lymph nodes in the pelvis also will be removed and checked to see if the cancer has spread from the prostate.
Radiation Therapy
This form of treatment (external beam or brachytherapy) uses high energy rays to kill the prostate cancer cells. In Stage I prostate cancer, it may be given instead of undergoing surgery, or it may be performed right after surgery to help further deplete any remaining cancer cells around the prostate.
Hormone Therapy
Male hormones – also known as androgens – cause prostate cancers to grow. Hormone therapy options include surgery to remove the testicles, which stops the production of testosterone, a major source for the development of male hormones. Other options include drug therapy including luteinizing hormone-releasing hormone (LH-RH) agonists or antiandrogens, which work to either prevent the testicles from producing testosterone or block the action of testosterone.


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