Prostate cancer can progress outside the prostate into surrounding tissue or through the blood or lymph systems. Imaging tests, the Gleason score, and prostate-specific antigen tests are used to determine the stage of the cancer. The stage of prostate cancer shows how aggressive it is and to what extent it has spread. If you are found to have stage 2 cancer, know that it is still localized and has not spread outside the prostate gland. But it may grow and metastasize if not treated early.
Usually, early-stage prostate cancer has no symptoms. The symptoms for stage 2 prostate cancer are mild and include trouble urinating, blood in semen, and pelvic discomfort. When you are diagnosed with stage 2 prostate cancer, your doctor will recommend treatment based on your overall health, age and whether or not you experience symptoms.
- Active surveillance – If your cancer is slow-growing with no symptoms, you might be considered for active surveillance. This means you’ll be carefully monitoring your cancer with your doctor. You’ll be expected to visit your doctor every six months and undergo a digital rectal exam and PSA testing. An annual prostate biopsy will also be needed. Actual surveillance is a commitment to follow the advice of the doctor.
- Radical prostatectomy – It is the surgical removal of the prostate, and it’s done through an abdominal incision. The patient receives general anaesthesia or an epidural. The nearby lymph nodes will be biopsied at the same time. Sometimes the surgeon may make incisions between the scrotum and the anus, although rarely is this method used since it does not provide access to the lymph nodes. The surgery can also be performed laparoscopically where a few small incisions are made to the abdomen.
- Radiation therapy – It is used to kill the cancer cells and includes external beam radiation therapy and brachytherapy. External beam radiation therapy (EBRT) is given for several weeks and include three-dimensional conformal radiation therapy (2D-CRT), intensity modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT) and proton beam radiation therapy. Brachytherapy is a procedure that entails inserting radioactive pellets directly into the prostate.
- Hormone therapy – It is used to lower male hormone levels or prevent them from fuelling the cancer cells. It is not a cure but helps in shrinking tumors and slowing their growth. It includes surgical castration also known as orchiectomy or luteinizing hormone-releasing hormone (LHRH) agonists which are drugs that are implanted or injected under the skin.
Prostate cancer and its treatment can cause problems with the urinary function as well as the erectile functioning. If stage 2 prostate metastasizes, it can reach the lymph system, bloodstream, and other tissues and sites. Later stage prostate cancer is life-threatening and is difficult to treat which is why early detection and treatment is key.