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Intermediate-risk prostate cancer has Grade Group 2 or 3 disease, a PSA between 10 and 20 or a tumour that fills more of the gland. Surgery or radiotherapy cure most men; the favourable half can sometimes be watched, and the unfavourable half is given a few months of hormone therapy with radiotherapy.
Intermediate-risk localised prostate cancer, in the NCCN scheme, has one or more of clinical stage T2b to T2c, Grade Group 2 or 3, or PSA 10 to 20 ng/mL, without high-risk features. It is split into favourable (one factor, Grade Group 1 or 2, under half of cores positive) and unfavourable (two or more factors, Grade Group 3, or more than half of cores positive), because the two behave differently. It is found by PSA, MRI and biopsy and staged clinically; bone scan and CT are reserved for unfavourable disease. Favourable disease is treated by radical prostatectomy, external beam radiotherapy or brachytherapy alone, and active surveillance is an option for selected men. Unfavourable disease is treated by prostatectomy with lymph node dissection, or radiotherapy with four to six months of androgen deprivation, or external beam radiotherapy plus a brachytherapy boost. CHHiP established 60 Gy in 20 fractions, HYPO-RT-PC showed seven fractions are equivalent, and PACE-B showed five stereotactic fractions match conventional radiotherapy at five years. Genomic classifiers and the ArteraAI pathology test are used to decide whether hormone therapy adds anything.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
About three quarters of cancers arise in the peripheral zone at the back of the gland, the part a finger or a biopsy needle reaches; drainage is to the obturator and iliac nodes.
Same organ: Prostate cancer, Ductal adenocarcinoma of the prostate, Localised prostate cancer, very low and low risk, Localised prostate cancer, high and very high risk, Biochemical recurrence of prostate cancer, Metastatic hormone-sensitive prostate cancer, Non-metastatic castration-resistant prostate cancer, Metastatic castration-resistant prostate cancer, Neuroendocrine and small-cell prostate cancer
Nothing recorded yet.
Also on OnCo: Symptoms and red flags · Early detection roadmap.
Radical prostatectomy, external beam radiotherapy (moderate or ultra-hypofractionated) or brachytherapy alone; active surveillance for selected men with low volume Grade Group 2 disease.
Radical prostatectomy with pelvic lymph node dissection, or external beam radiotherapy with four to six months of androgen deprivation, or external beam plus brachytherapy boost.
ArteraAI Prostate predicts benefit from short-course androgen deprivation with radiotherapy; Decipher stratifies risk.
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Long-term data support active surveillance as a safe choice for low and much intermediate-risk disease, while the lower metastasis rate with treatment informs the discussion for men with longer life expectancy.
The disparity in prostate cancer death among Black men in the United States is, stage for stage and treatment for treatment, largely a disparity in getting standard care rather than in tumour biology. The disparity that survives equal access is in dying of everything else, which is the part a cancer service is least organised to fix and most able to measure.
The limit of what a prostate scan can be asked to do. It is a good triage test for whether to biopsy and a poor map of where every tumour is, which matters for anyone being offered treatment to part of the gland or follow-up by imaging alone.
The clearest evidence that radical treatment of localised prostate cancer saves lives when the cancer was found clinically rather than by a blood test, and the clearest single statement of what grade does: a Gleason score above 7 carried ten times the risk of death of a score of 6 or lower in the same trial.
The current shape of the screening question in the United States, and the best short statement of the trade-off in numbers a man can weigh. The three-to-one ratio between metastatic cases prevented and deaths prevented is also the argument for using metastatic presentation, not mortality, to judge a screening programme sooner.
The trial that made observation a defensible choice for low-risk prostate cancer found by a blood test, and that supplied the number a man needs when weighing surgery: the progression it prevents is mostly progression on a scan or a blood test, and the harms it causes are felt every day.
The evidence that put a scan in front of the biopsy. It reduces the number of men who are biopsied at all, reduces the number of harmless cancers found, and increases the number of dangerous ones, which is the only combination that improves a screening pathway on both sides at once.
Moderate hypofractionation (60 Gy in 20 fractions) is a standard of care for localised prostate cancer, halving the number of hospital visits.
Query for this cancer: (TITLE:"Localised prostate cancer, intermediate risk" OR ABSTRACT:"Localised prostate cancer, intermediate risk" OR TITLE:"Intermediate-risk prostate cancer" OR ABSTRACT:"Intermediate-risk prostate cancer" OR TITLE:"Favourable intermediate risk" OR ABSTRACT:"Favourable intermediate risk" OR TITLE:"Unfavourable intermediate risk" OR ABSTRACT:"Unfavourable intermediate risk" OR TITLE:"Grade Group 2 and 3 prostate cancer" OR ABSTRACT:"Grade Group 2 and 3 prostate cancer" OR TITLE:"Cambridge Prognostic Group 2" OR ABSTRACT:"Cambridge Prognostic Group 2") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Localised prostate cancer, intermediate risk, not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Answer a few questions from a report and read the guideline statement that applies, quoted word for word with its source. Educational aids to prepare for an appointment, not advice.
Prostate Cancer UK says acute urine retention is when you suddenly and painfully cannot urinate, that it needs treating straight away, and to call your doctor or nurse or go to your nearest accident and emergency department, where they may need to drain the bladder with a catheter. Make sure they know what prostate cancer treatment you have had.
Prostate Cancer UK says to go to your nearest accident and emergency department straight away if your erection lasts more than four hours, that this is called priapism and is considered a medical emergency but can be treated, and that it affects fewer than 1 in 100 men using treatments for erection problems and about 1 in 100 using injections. Walking, squatting, passing urine or something cold may help while you get there.
A swollen painful calf, or sudden breathlessness with chest pain; the tamoxifen boxed warning covers pulmonary embolism and stroke.
See all on the product pages:BrachytherapyLeuprolide (leuprorelin) and GnRH agonistsRobotic & minimally invasive surgery·Printable cards in the navigator
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