Locally advanced prostate cancer

Doctors can describe prostate cancer as localised, locally advanced and advanced. Locally advanced prostate cancer means 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 (seminal vesicles)
  • body organs nearby such as the back passage (rectum) or neck of the bladder
  • lymph nodes close to the prostate gland
Diagram showing locally advanced prostate cancer

Doctors may also describe prostate cancer using the TNM stage and grade. 

TNM stage

The TNM staging system stands for Tumour, Node, Metastasis.

  • T describes the size of the tumour
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

In the TNM staging system locally advanced prostate cancer is the same as one of the following:

  • T3, N0, M0
  • T4, N0, M0
  • Any T, N1, M0


The grade of prostate cancer tells you how much the cancer cells look like normal cells. The Gleason score is the most common system used to grade prostate cancer. 

High risk prostate cancer

High risk localised prostate cancer is also a locally advanced prostate cancer. This means that even if your cancer is contained within the prostate gland, your doctor might describe it as locally advanced if:

  • your PSA level is higher than 20ng/ml
  • or your Gleason score is between 8 and 10


Treatment depends on a number of things such as:

  • your age and general health
  • how you feel about the treatments and side effects
  • your type of cancer (the type of cells the cancer started in)

If you don’t have treatment straight away

Your doctor might monitor your prostate cancer if you don’t have any symptoms. You can start treatment if you get symptoms. This is called watchful waiting. 

If you have treatment

Treatment options include:

  • external radiotherapy with hormone therapy
  • surgery to remove your prostate
  • hormone therapy on its own or with chemotherapy
  • cryotherapy as part of a clinical trial
  • high frequency ultrasound therapy (HIFU), as part of a clinical trial
Last reviewed: 
15 Jul 2019
  • AJCC Cancer Staging Manual (8th edition)
    S Edge and others
    Springer,  2017

  • Prostate cancer: diagnosis and management 
    National Institute for Health and Care Excellence (NICE), January 2019

  • Cancer of the prostate: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    C Parker and others,
    Annals of Oncology, 2015. Volume 26, Pages 569-577

  • Guidelines on Prostate Cancer
    European Association of Urology, 2015

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