Principles of staging treatment for prostate cancer

For prostate cancer, the most common staging method currently is the Whitmore-Jewett method, which divides prostate cancer into four stages: A, B, C, and D according to the growth of the tumor. Due to different infiltration and metastasis conditions, the treatment methods for each stage are also different. The specific plan to be selected should be based on comprehensive considerations such as the patient's age, systemic symptoms, cancer stage, and immune status.

Stage A: The tumor is hidden in the prostate and can be divided into stages A1 and A2. In stage A1, the tumor is concentrated in one place and is well differentiated.

It is generally not recommended to perform radical prostatectomy or radiation or endocrine therapy immediately. For stage A2 tumors that are diffuse in the prostate and poorly differentiated, radical prostatectomy or radiation therapy may be considered.

Stage B: Nodules can be felt during rectal examination, and the tumor is confined to the prostate capsule. Radical surgery for prostate cancer and pelvic lymph node dissection, orchiectomy, endocrine therapy, radiotherapy, and intra-tissue radiotherapy should be performed.

Stage C: The tumor has infiltrated or exceeded the prostate capsule, and no lymphatic or hematogenous metastasis has been found. Patients with poor physical fitness can use extended-range external radiotherapy, intra-tissue radiotherapy and external radiotherapy, which are suitable for patients without lymph node metastasis and distant metastasis and in good general condition.

Stage D: Distant metastasis has been found, and treatment is mainly based on endocrine therapy, chemotherapy, and immunotherapy, and pelvic lymph node dissection can be performed.