Prostate cancer is something that most men prefer not to think about.
It’s a scary topic that often gets pushed to the back of our minds.
But with an estimated 161,000 new cases and 26,700 deaths in 2017, it’s important to address this issue. These statistics warrant our attention.
One in 39 men will die from this disease. However, most cases are luckily confined to the prostate in something known as localized prostate cancer.
Stage 2 prostate cancer falls into this category and has a good prognosis.
We may not want to talk about it, but we need to, and prostate cancer stage 2 may not be as scary as you may think.
So, let’s dive into the details of how to best manage this disease, the symptoms, prognosis, survival rate, and much more.
What is stage 2 prostate cancer?
Prostate cancer stages 1 and 2 are still considered localized cancer. In particular, stage 2 is defined as a tumor found in the prostate only, without any type of spread to nearby tissues or lymph nodes. The PSA level can be medium or low, and the tumor is small.
However, this cancer has the risk of spreading or growing if not detected and treated early. As such, stage 2 prostate cancer is considered a crucial stage to diagnose and treat this disease early.
We can further divide stage 2 into 2a, 2b, and 2c. However, regardless of this division, stage 2 prostate cancer PSA levels are always between 10 and 20 ng/mL. What changes is the location of cancer and the Gleason score.
In stage 2a prostate cancer, the tumor is very small and difficult to feel in a digital rectal exam. The Gleason score is 6 or less, and the tumor only takes one-half of the prostate.
In stage 2b prostate cancer, the tumor is larger and less differentiated. The Gleason score is 7, and the tumor can be located in one-half of the prostate or on both sides.
In stage 2c prostate cancer, the tumor has a Gleason score of 7 or 8. It is located on one or both sides of the prostate, and the grade group is higher, meaning the cells are less differentiated.
What are the symptoms of stage 2 prostate cancer?
One challenge of localized prostate cancer is its often asymptomatic nature, which in layman terms a “silent disease”. Stage 2 prostate cancer symptoms can be completely absent, and patients can be apparently healthy while cancer is growing in the gland.
While early-stage prostate cancer usually has no symptoms, you could have lower urinary tract symptoms (LUTS) and other urinary problems attributed to benign prostatic hyperplasia (BPH).
Around 50% of men over 50 will experience LUTS related to BPH, and these symptoms warn them in the first place. But this type of incidental diagnosis of early-stage cancer can be missed in patients without BPH.
Besides urinary symptoms due to BPH, other problems you may experience in localized prostate cancer include hematuria (blood in urine), hematospermia (blood in semen), and new-onset erectile dysfunction.
These symptoms may also lead to early screening and diagnosis of stage 2 prostate cancer.
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When to see a doctor
If you have recurrent urinary symptoms such as increased urinary frequency, slow urinary stream, and urinary dribble, it is recommended to talk to your doctor right away.
You may have BPH instead of prostate cancer, but it is always a good idea to rule out the worst-case scenario.
Stage 2 prostate cancer prognosis is still excellent, but you need to start treatment as soon as possible. Taking proactive steps to screen for prostate cancer is strongly recommended.
Screening with digital rectal examination and PSA tests is offered to men after 50 years old or after 45 years in case of increased risk (males with a family history of prostate cancer and African American men).
You may even need to screen after 40 years if several males in your family were diagnosed with prostate cancer before age 65.
Treatment options at this stage
Prostate cancer treatment in stage 2 can include the following strategies:
1. Watchful waiting
Conservative palliative strategy is one option, and it is more commonly known as watchful waiting. It involves closely monitoring cancer and delaying aggressive treatment until necessary.
This approach is often recommended for elderly and frail individuals with asymptomatic prostate cancer when they are very unlikely to die from prostate cancer.
However, there is a risk with watchful waiting of missing accelerated growth in cancer development.
2. Active surveillance
This is another conservative treatment option, also known as deferred curative strategy. Similar to watchful waiting, the goal is to offer aggressive treatment only when disease progression is more likely.
Active surveillance features more frequent follow-ups and exams. In the first year, PSA tests are repeated every 3 to 4 months. After that, patients undergo imaging tests.
Your doctor may recommend repeated prostate biopsies when biomarkers do not meet imaging findings.
The likelihood of missing accelerated cancer growth is reduced compared to watchful waiting, but there’s still a risk.
3. Radiotherapy
Radiation therapy can also be delivered to localized prostate cancer to achieve remission with less toxicity than systemic therapy.
There are many delivery methods, including external beam radiation therapy and brachytherapy. Both can be applied along with androgen deprivation therapy for better results.
These therapies have risks of genitourinary and gastrointestinal problems or urinary side effects such as incontinence and urinary retention in the case of brachytherapy.
4. Radical prostatectomy
Younger patients and those with a higher chance of cancer spread are offered surgical options to take out cancer.
Radical prostatectomy can be done through different methods, including open surgery, laparoscopic surgery, and robotic-assisted surgery.
Surgery risks include bleeding, remaining urinary symptoms, incontinence, and sexual dysfunction.
These methods can be used interchangeably to maintain cancer at bay and treat any symptoms that may arise.
Can stage 2 prostate cancer be effectively treated?
Since cancer is confined to the prostate, this stage is curable when treatment starts early in the course of the disease.
Stage 2 prostate cancer treatment is easier and has more manageable side effects than chemotherapy.
However, not all patients with stage 2 prostate cancer will require treatment. Some have a limited life expectancy and are more likely to die with prostate cancer and not from it.
So, depending on each case, your doctor may recommend a very specific course of treatment or a conservative approach such as watchful waiting.
Survival rates for stage 2 prostate cancer
The 5-year relative survival rate for all prostate cancers is 97.5%. And for localized prostate cancers, like stage 1 and stage 2 cancers, the survival rate is almost 100%.
Thus, a prostate cancer diagnosis can be scary, but the odds of survival are pretty high.
Once your primary treatment ends and there’s no sign of cancer, you’re in a state of remission.
However, any cancer can recur, which is why it’s crucial to stay on top of routine physical exams and PSA testing per your doctor’s recommendations.
It’s important to note that each person’s outlook will be different. Lifestyle factors and other risks can play a role in your recovery.
Conclusion
Stage 2 prostate cancer is localized in the prostate, and it is easy to treat with surgery, radiotherapy, and conservative treatment.
However, since prostate cancer is a slow-progressing type of cancer and not all patients with this ailment will die from it, your doctor may recommend an approach like watchful waiting, which involves follow-up and no aggressive treatment unless cancer progression is evident.
Understanding the statistics and facts about prostate cancer can help ease some of the fear and uncertainty that can accompany a diagnosis like this.
Don’t be afraid to ask your doctor questions and seek out further information to make informed decisions about your health.
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