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This stage 1 prostate cancer guide explains diagnosis, Gleason scores, and the choice between surgery, radiation and active surveillance.
This guide is designed to provide you with an educational overview of your diagnosis, stage 1 prostate adenocarcinoma. The information presented here will serve as a foundation for productive conversations with your oncologist and the rest of your care team.
Prostate adenocarcinoma is the most common type of prostate cancer, developing from the gland cells of the prostate. Your specific diagnosis, stage 1, means the cancer is small, localized, and confined entirely within the prostate gland. It is not aggressive and has not spread to lymph nodes or distant organs.
This early stage is often detected through routine screenings, such as a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE), before any symptoms arise. Because the disease is limited, the prognosis for stage 1 prostate cancer is generally excellent.
The two main factors used to classify your cancer are:
The initial suspicion of prostate cancer is often raised by an elevated PSA level or an abnormal DRE. To confirm the diagnosis and determine the stage, the following procedures are used:
The prognosis for Stage 1 prostate adenocarcinoma is highly favorable.
Your specific long-term outlook will be discussed with your oncologist, considering your Gleason score, PSA level, age and overall health.
“A prostate cancer diagnosis can obviously be very devastating, but the nice thing to know is that it's one of the most treatable cancers out there,” Dr. Ravi Munver, vice chair of Urology, the chief of Minimally Invasive and Robotic Surgery, the director of Robotic Surgery and Minimally Invasive Urological Oncology Fellowship, and the director of the Living Donor Kidney Surgery Program, all at the John Theurer Cancer Center, part of Hackensack Meridian Health, as well as a professor of urology at the School of Medicine and vice chair of the Department of Urology at Hackensack University, said in an interview with CURE.
“So, when patients come to see their caregiver to talk about prostate cancer, they should first do their research. There's a lot of research you can do — you can go on the internet; you can talk to friends and family.”
For stage 1, low-risk prostate cancer, there are typically three main approaches. The choice of treatment involves weighing the potential side effects of intervention against the slight risk of cancer progression.
Active Surveillance: This is often the preferred option for very low- and low-risk stage 1 cancer. What is active surveillance? Instead of immediate treatment, the cancer is closely monitored with regular PSA tests, DREs, and periodic confirmatory biopsies. The goal is to defer or avoid the side effects of treatment (such as urinary, bowel, and sexual dysfunction) while ensuring that curative treatment can be started if the cancer shows signs of progression.
Dr. David A. Taub, a urologist and the director of urologic oncology at Eugene M. & Christine E. Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health, explained in an interview with CURE that some international studies have shown that some of these earlier-stage and non-aggressive cancers can be present for 10 or 15 years without causing any increase in death or complications.
“So, watching the cancer and surveilling it is an option,” Taub said. “We do that by checking the PSA on a more regular basis, about twice a year, and checking the MRI a little more frequently, as well as repeating biopsies to make sure nothing is progressing. Active surveillance is the mainstay for low-risk prostate cancer.”
The most important discussion with your oncologist will be around active surveillance. Given the low-risk nature of stage 1 disease, many patients can safely postpone or avoid aggressive treatment.
Managing your diagnosis is an ongoing process that extends beyond treatment decisions.
Stage 1 prostate adenocarcinoma is a highly treatable, low-risk cancer. Patients have time to carefully consider their options.
Your primary goal should be an open, honest dialogue with your oncologist to determine the best approach for you, one that balances the certainty of treatment side effects against the low risk of cancer progression. Be sure to ask about your specific Gleason score and risk group classification and discuss active surveillance in detail. Taking an active role in these decisions is the first step on your journey toward successful management and recovery.
Editor’s Note: This guide is designed to be a starting point. Your personal experience will be unique. By using this information as a foundation for your discussions, you can partner with your oncologist to make the best decisions for your health.
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