Prostate cancer has multiple stages that describe how aggressive the cancer is and how far it has spread. Imaging tests, prostate-specific antigen (PSA) levels, and the Gleason score can determine a person’s cancer stage.
If you have stage 2 prostate cancer, it is still localized to the prostate gland, but it’s more likely than stage 1 to grow and spread to other parts of the body.
But doctors can treat stage 2 prostate cancer by various means, and the general outlook is positive.
Prostate cancer is treatable and survivable. Diagnosing cancer in stage 2 improves a person’s overall long term survival rate.
Relative survival rates estimate the likelihood of a person surviving their cancer, but they don’t take into account other lifestyle factors or other risks. Each person’s outlook will be different.
Once your main treatment ends and there’s no sign of cancer, you’re in a state of remission. Your doctor can still help you with the short and long-term side effects of treatment.
Any cancer can recur. So you’ll need to return for routine physical exams and PSA testing per your doctor’s recommendations. A rise in your PSA level doesn’t necessarily mean cancer has returned. Additional procedures, like imaging tests, can help determine if it has.
Your doctor will recommend treatment based on several factors, including your age, overall health, and whether or not you’re having symptoms.
Your doctor might consider active surveillance if you have a slow-growing stage 2 prostate cancer and no symptoms. That means you won’t actually be treating the cancer, but you’ll be monitoring it carefully with your doctor.
This might involve visiting your doctor every 6 months, which would include a digital rectal exam and PSA testing. You might also need an annual prostate biopsy.
Active surveillance is only an option if you can commit to following up as advised by your doctor. You may still require treatment if your cancer progresses.
Treatment may involve a combination of therapies.
Radical prostatectomy is the surgical removal of the prostate. Surgeons may remove the prostate through an open incision at the abdomen.
They may also opt for less invasive procedures, like a laparoscopy.
This procedure involves a surgeon inserting a camera, a laparoscope, and other small instruments into the abdomen through small incisions. They then perform the surgery using a video feed from the laparoscope.
During any surgery you’ll have either general anesthesia or an epidural. The surgeon may biopsy nearby lymph nodes at the same time.
Following surgery, you will stay in the hospital for a night or two. You’ll also require a temporary catheter and must limit your activities for several weeks. People who have laparoscopies
Sometimes the surgeon can make the incision between the anus and scrotum (perinea) instead of through the abdomen. This method is less common because it doesn’t allow access to the lymph nodes.
Potential side effects of prostate surgery include:
- bad reaction to anesthesia
- bleeding, infection, or blood clots
- damage to nearby organs
- urinary incontinence
- erectile dysfunction
- lymphedema, a collection of fluid due to lymph node removal
Radiation therapy is used to destroy cancer cells. In external beam radiation therapy (EBRT), radiation beams come from a machine outside the body. Treatment is usually given 5 days a week for several weeks. Types of EBRT include:
- three-dimensional conformal radiation therapy (3D-CRT)
- intensity-modulated radiation therapy (IMRT)
- stereotactic body radiation therapy (SBRT)
- proton beam radiation therapy
Possible side effects include:
- skin irritation
- urinary problems
- bowel problems
- erection problems
Brachytherapy is internal radiation therapy, which involves a lot less time on your part. A surgeon inserts radioactive pellets directly into your prostate. A permanent low dose rate (LDR) gives off radiation for up to a few months. Alternatively, there’s a temporary high dose rate (HDR) that only lasts a few days.
Potential side effects include:
- movement of the pellets
- urinary problems
- bowel problems
- erection problems
Hormone therapy lowers male hormone levels or blocks them from fueling cancer cells. It’s not a cure for prostate cancer, but it does a good job of shrinking tumors and slowing growth.
One way to accomplish this is through surgical castration (orchiectomy), as the testicles produce the most male hormones.
Another way to reduce testosterone is with luteinizing hormone-releasing hormone (LHRH) agonists. These drugs are injected or implanted under the skin. Some LHRH antagonists are:
- goserelin (Zoladex)
- histrelin (Vantas)
- leuprolide (Eligard, Lupron)
- triptorelin (Trelstar)
Other options include oral antiandrogens. These treatments, which can be given in combination with antiandrogens in some patients, include:
- bicalutamide (Casodex)
- enzalutamide (Xtandi)
- flutamide (Eulexin)
- nilutamide (Nilandron)
Some potential side effects of hormone therapy are:
- loss of sex drive or erectile dysfunction
- shrinkage of testicles and penis
- hot flashes
- breast tenderness
- osteoporosis, anemia, or increased cholesterol levels
- loss of muscle mass or weight gain
- fatigue or depression
Enzalutamide can also cause diarrhea or dizziness.
Antiandrogens tend to have fewer sexual side effects than LHRH agonists or surgical castration. Many side effects of hormone therapy are treatable.
Often there are no symptoms in the early stages of prostate cancer. Stage 2 symptoms can still be mild, but may include:
- trouble urinating
- blood in your semen
- pelvic discomfort
Prostate cancer and treatment can lead to problems with urination as well as erectile dysfunction.
If stage 2 prostate cancer spreads outside the prostate, it can reach nearby tissues, the lymph system, or the bloodstream. From there, it can metastasize to distant sites. Later stage prostate cancer is difficult to treat and can be life-threatening.
If you’re having trouble dealing with prostate cancer or side effects of treatment, or want to connect with others, visit:
The outlook for a person with stage 2 prostate cancer is usually positive. Discovering the cancer at this stage means that it’s normally localized to the prostate, and therefore treatable.
While no two patients will have the same experience, research estimates that close to
Treatments including surgery, radiation therapy, and hormone therapy can remove cancerous cells or manage their growth. While these treatments may have short term side effects, they’re effective in improving a person’s outlook.
Support groups are also available for those going through or recovering from prostate cancer treatment, which you may also find helpful.