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Locally advanced prostate cancer

Find out about locally advanced prostate cancer and how it might affect you.

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

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
Diagram showing locally advanced prostate cancer

TNM stages

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


What your treatment depends on

Your risk group helps your doctor decide which treatment you need. Treatment also depends on:

  • 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
  • hormone therapy on its own
  • cryotherapy as part of a clinical trial
  • high frequency ultrasound therapy (HIFU), as part of a clinical trial

A small number of men might have surgery to remove the prostate gland. But this isn’t used very often for locally advanced cancer.

Last reviewed: 
05 Jul 2016
  • AJCC Cancer Staging Manual (7th Edition)
    S Edge and others
    Springer,  2011

  • Cancer of the prostate: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    C  Parker and others
    Annals of Oncology, 2015. Vol.26 (suppl 5): v69-v77

  • Prostate cancer: diagnosis and management 
    National Institute for Health and Care Excellence (NICE), January 2014

  • Guidelines on Prostate Cancer
    European Association of Urology, 2015

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