Locally advanced prostate cancer is an advanced form of the disease. Surgery, radiation, or other treatments can often treat it successfully.

Prostate cancer develops when cells grow out of control in the prostate, a small gland in the lower abdomen of males.

Doctors often describe prostate cancer as localized, locally advanced, or metastatic:

  • Localized prostate cancer: The cancer has not spread outside the prostate.
  • Locally advanced prostate cancer: The cancer has spread to nearby tissues outside the prostate but not to distant sites, like the lymph nodes or bones.
  • Metastatic prostate cancer: The cancer has spread outside the prostate and to distant sites throughout the body.

Doctors may then further classify prostate cancer in terms of risk groups. The risk group helps doctors decide on a treatment plan.

Read on to learn more about how doctors diagnose and treat locally advanced prostate cancer and what to expect regarding your outlook.

The prostate is a small gland in the lower abdomen under the bladder in males.

Locally advanced prostate cancer means prostate cancer has grown through the covering of the prostate gland. It may have spread into the tissue around the prostate or other nearby organs, like the tubes that carry semen (seminal vesicles), the urethral sphincter, or the wall of the pelvis.

However, the cancer has not spread any further in the body at this point.

The most common staging system doctors use for prostate cancer is the American Joint Committee on Cancer’s tumor, nodes, and metastasis (TNM) system.

There are 1–4 main stages in the TNM system. Some stages are broken down further based on the results of lab tests, like your PSA level at the time of diagnosis and the results of a prostate biopsy.

Locally advanced prostate cancer is considered stage 3 because the cancer has already grown outside the prostate to other nearby tissues next to the prostate, but it has not spread to the lymph nodes or distant sites in the body.

Prostate cancer often grows slowly, so you may not have any symptoms at first. However, once the cancer spreads outside the prostate, it can cause symptoms like:

Doctors may diagnose locally advanced prostate cancer using a variety of tests and techniques, including:

Biopsy results are used to further define the cancer stage and determine your risk group (low, intermediate, or high risk).

But it can be complex. Stage grouping is based on many factors, such as:

  • Gleason score, which is a measure of how quickly the cancer is expected to grow and spread
  • the extent of the main tumor
  • whether the cancer has spread to nearby lymph nodes
  • whether the cancer has spread to other parts of the body
  • your PSA level at the time of diagnosis

If your prostate cancer hasn’t yet spread to distant parts of the body, doctors use your overall risk group to plan your treatment. Other factors like your age, preferences, and general health are also factored into the decision.

There are three main treatment options for locally advanced prostate cancer:

  • Active surveillance: Your doctor may recommend delaying treatment with careful monitoring, especially if your cancer is considered low risk.
  • Surgery: In some cases, doctors may recommend removing the prostate. This surgery is called radical prostatectomy.
  • Radiation therapy: Radiation is sometimes combined with hormone therapy or used after surgery to improve outcomes.

A 5-year survival rate is an estimate of the percentage of people with the same type and stage of cancer who are still alive 5 years after diagnosis compared with the larger population.

The American Cancer Society uses the Surveillance, Epidemiology, and End Results (SEER) database for cancer survival statistics. These estimates are based on outcomes of studies from the past. They can’t tell you how long you will live, but they might give you a better idea of how well treatment could work.

According to the American Cancer Society, the 5-year survival rate for prostate cancer that has spread outside the prostate but not to distant sites throughout the body is greater than 99%.

Here are answers to common questions about locally advanced prostate cancer:

Is locally advanced prostate cancer curable?

Some doctors may define cancer as “cured” if a person has shown no signs of cancer for at least 5 years. In this sense, treatment can cure locally advanced prostate cancer.

Many people with locally advanced prostate cancer don’t have any signs of cancer for at least 5 years after treatment.

What is the difference between locally advanced and advanced prostate cancer?

The main difference between locally advanced and advanced prostate cancer is how far the cancer has spread.

In both cases, the cancer has spread outside the prostate. But in locally advanced cancer, the cancer has only spread to nearby tissues next to the prostate.

In advanced prostate cancer, the cancer has also spread to distant sites in the body, like the lymph nodes or bones.

If you receive a diagnosis of locally advanced prostate cancer, speak with your doctor about your risk group and what it means for your treatment and overall outlook. They can help you understand your options and what to expect.