Stage 1 (I) Prostate Cancer

Summary: At stage 1, the first stage, prostate cancer has limited development, it is found only within the prostate gland & there are no symptoms. For treatment, a watch and wait approach is often taken. Stage 1 prostate cancer survival rates are high.

Introduction - What Is Stage 1 Prostate Cancer?

Prostate cancer is a type of cancer which begins in the prostate gland of men. This gland, and the seminal vesicles which are connected to it, produce seminal fluid which is mixed with semen. In men, prostate cancer is the most common type of cancer to develop.

Beginning in the prostate, left undetected and untreated, prostate cancer can metastasize, spreading to other areas of the body. To help diagnose prostate cancer, and to choose appropriate treatments, physicians first assess how widespread and developed the cancer has become.

Stage 1 prostate cancer refers to prostate cancer that is at the first stage; the cancer is not well developed and is limited to the prostate gland.

Diagnosing Stage 1 Prostate Cancer

The TNM system is a popular grading system used by physicians to stage the development of a cancer. TNM is a four stage system (1 , 2 , 3, 4). Stage 1, is the first stage, in which prostate cancer is not very developed and is found only in the prostate gland. Stage 4 is the final stage in which prostate cancer is aggressive and has spread (metastasized) to other parts of the body.

To diagnose stage 1 prostate cancer, the physician will consider a number of factors which may include the results from :

  • a physical examination
  • needle biopsy
  • imaging scans
  • Gleason
  • PSA tests

As stage 1 prostate cancer is not well developed and found only in the prostate gland, a physical examination will find no noticeable tumors. Also, for a first stage diagnosis, imaging scans such as MRI and CT, will not detect any tumors in the prostate gland.

For an accurate stage 1 diagnosis, a physician will also consider the patient's PSA and Gleason scores (where these tests have been taken).

The protein, prostate-specific androgen (PSA), is created in the prostate gland and can be found in the blood. Higher levels of PSA are linked to prostate cancer (along with several other conditions of the prostate).

Where a PSA test has been taken, prostate cancer will be stage 1 if the patients PSA score is less than 10 (and the requirements from other factors such as a Gleason score, location and coverage of the cancer are met).

The Gleason test is used to assess how aggressive a cancer is. The arrangement of prostate cancer cells are graded from tissue samples using a microscope; the pattern of these cells reflect the aggressiveness of the cancer. A Gleason score of 6 or less indicates stage 1 prostate cancer (providing the requirements from other factors such as PSA score, location and coverage of the cancer are met).

To summarize, stage 1 prostate cancer is diagnosed when:

- The Gleason score is 6 or lower AND the PSA score is less than 10 AND cancer is found in one prostate gland lobe with a coverage of half or less.

OR

- Gleason & PSA scores are not known AND cancer is found in one prostate gland lobe with a coverage of half or less AND it is not shown by imaging scans or touched and felt by digital examination.

OR

- The Gleason score is 6 or lower AND the PSA score is less than 10 AND a tumor is detected by needle biopsy or a small amount of prostate cancer is found during surgery for other matters.

Stage 1 Prostate Cancer Symptoms

As stage 1 prostate cancer is confined to the prostate, any symptoms would affect this area of the body. However, stage 1 prostate cancer cannot be detected by physical examination and cancer cells within the prostate gland are limited in number. Because of this, a patient with first stage prostate cancer often has no noticeable symptoms. There have not been significant physical changes within the body to cause problems.

See also, 'Symptoms Of Prostate Cancer'.

Stage 1 Prostate Cancer Treatment

Where stage 1 prostate cancer patients are of an advanced age, a watch and wait approach* is usually chosen over conventional medical treatment. This is because tumors can be slow growing at this early first stage and the survival rate is very high. For example, a person over 80 years old who is diagnosed with stage 1 prostate cancer could be more likely to die from other causes. Treatment could mean the benefits are outweighed by negative side effects.
*also referred to as 'watchful waiting'

However, in cases where a younger person has been diagnosed with first stage prostate cancer, there may be more immediacy in treating the disease rather than monitoring it. A younger person will have more years ahead of them in which the cancer can develop, and they may also make a better recovery following medical treatment.

When treatment is given, the treatment options are similar to those for stage 2 prostate cancer. The prostate gland may be removed through a procedure known as a radical prostatectomy. Radiation therapy and hormonal therapy may also be administered to shrink any tumors.

Stage 1 Prostate Cancer Prognosis & Survival Rates

Cancer survival rates help to give a more accurate prognosis and provide a likely outcome of the disease.

Survival rates for prostate cancer are often expressed as a percentage chance of the person surviving for a set number of years following an initial diagnosis. The prognosis (or outcome) for stage 1 prostate cancer is good. Using data quoted by the American Cancer Society (ACS), the 5 year survival rate for stage 1 prostate cancer is nearly 100%, the 10 year rate is 98% and the 15 year survival rate 93%. Given that many people first diagnosed with stage 1 prostate cancer are already in their advanced years, a 93% chance of surviving 15 years is high.

These survival rates are similar to the next stage: stage 2 prostate cancer.

It must be noted that when using survival rates each case is different; the age, current health and health history of a man can influence their overall survival rate.

Also, the advancement of medical science means that each year techniques which detect & treat cancer earlier are being developed; these survival rates may be even higher in the future.