Locally advanced prostate cancer

Locally advanced prostate cancer means that the cancer has broken through the capsule (covering) of the prostate gland. It may have spread into the:

• tissue around the prostate
• the tubes that carry semen. These are the seminal vesicles
• body organs nearby such as the back passage or bladder
• lymph nodes close to the prostate gland

Doctors use the Cambridge Prognostic Group (CPG) to divide prostate cancer into 5 prognostic groups. This tells you how likely it is that your cancer will grow or spread. 

In the TNM staging system, locally advanced prostate cancer is the same as T3 or T4. Below is a simplified description of the T3 and T4 stage:

T3 means the cancer has broken through the capsule (covering) of the prostate gland.

T4 means the cancer has spread into other body organs nearby, such as the back passage, bladder, or the pelvic wall.

We have a separate page about prostate cancer that is contained within the prostate gland. This is also called localised prostate cancer. 

Prognostic groups for locally advanced prostate cancer

In the UK, doctors now use the Cambridge Prognostic Group (CPG) for locally advanced prostate cancer. This divides prostate cancer into 5 prognostic groups.

The term prognostic refers to your outlook (prognosis ). So your prognostic group tells you how likely it is that your cancer will grow or spread. And how likely it is that you will die from your cancer. This helps your doctor recommend if you need treatment, and the type of treatment you need.

There are 5 risk groups. These are from CPG 1 to CPG 5.

Your group depends on:

• your Grade Group or Gleason score
• the prostate specific antigen (PSA) level
• how far the cancer has grown in your prostate - this is the T stage

Ask your doctor or specialist nurse if you have any questions about this.

If your cancer has spread

When prostate cancer spreads to another part of your body, it is called metastatic prostate cancer. Doctors don't use prognostic groups for prostate cancer that has spread. 

Treatment for locally advanced prostate cancer

Treatment for locally advanced prostate cancer depends on your prognostic group. It also depends on a number of things such as:

• your age and general health
• how you feel about the treatments and side effects

Your doctor usually recommends you have treatment. Treatment might include:

• surgery to remove your prostate  - this is called a prostatectomy
• external radiotherapy with or without hormone therapy  
• internal radiotherapy - this is called brachytherapy