Understanding your prostate cancer diagnosis

A diagnosis of prostate cancer can feel overwhelming. Many men describe the experience as confusing, filled with medical terms that are difficult to interpret, and accompanied by uncertainty about what the future holds. Yet understanding the disease is one of the most important steps toward regaining a sense of control. Andrew Hunt, MD, radiation oncologist in Wichita, Kansas, shares what you may expect when diagnosed with prostate cancer and what treatments are available to get the care you need at Ascension Via Christi.

How common is prostate cancer?

According to the American Cancer Society, prostate cancer is among the most frequently diagnosed cancers in men. In the United States, it is second only to skin cancer and accounts for about one in eight cancer diagnoses. Worldwide, prostate cancer is also highly prevalent, especially in developed countries where screening with prostate-specific antigen (PSA) testing is more common.

Most diagnoses occur in men over 65, but younger men can also be affected, particularly if they carry certain genetic mutations such as BRCA1 or BRCA2, or if they have a strong family history. African American men are at higher risk and often present with more aggressive disease.

The good news is that prostate cancer often grows slowly. Many cases are identified early, before the cancer spreads, and treatment outcomes are generally very favorable compared to other cancers. For some men, prostate cancer will never cause symptoms or threaten lifespan.

Understanding cancer stages and survival by stage

Prostate cancer staging describes how far the disease has progressed at the time of diagnosis. Staging is vital because it helps physicians recommend treatment strategies and provides an estimate of survival.

Localized, regional and advanced disease

• Stage I and II (Localized disease): The cancer is confined to the prostate. These cancers are typically detected by PSA screening or biopsy. Survival rates are excellent, with nearly all men living at least 10 years following diagnosis.
• Stage III (Regional disease): The cancer has grown outside the prostate into nearby tissues, such as the seminal vesicles. Survival remains favorable, especially with treatment.
• Stage IV (Advanced or metastatic disease): Cancer has spread to distant lymph nodes, bones, or other organs. While this stage is more difficult to cure, advances in systemic treatments have extended survival and improved quality of life.

The Gleason score

Beyond stage, the Gleason score is a critical part of understanding prostate cancer. This score is based on how prostate tissue looks under a microscope after biopsy.

• A Gleason score of 6 represents low-grade cancer, usually slow-growing.
• A score of 7 represents intermediate risk.
• Scores of 8 to 10 indicate high-grade cancer that is more aggressive and more likely to spread.

The Gleason score is often reported alongside PSA level and stage to classify the cancer into risk groups.

Risk categories

Your doctor will group patients into risk categories that combine stage, PSA level, and Gleason score:

• Low risk: Localized cancer, PSA less than 10, and Gleason 6.
• Intermediate risk: PSA between 10 and 20, or Gleason 7, or more extensive disease still confined to the prostate.
• Favorable intermediate risk: Defined by a single intermediate-risk factor (for example, PSA 10–20, Gleason 3+4=7, or clinical stage T2b–T2c) with otherwise low-risk features. Men in this category may still be candidates for active surveillance in selected cases, or may be treated effectively with radiation therapy alone.
• Unfavorable intermediate risk: Defined by multiple intermediate-risk factors, or a Gleason 4+3=7 pattern. These men have a higher likelihood of progression and are typically advised to undergo radiation combined with short-term hormone therapy or surgery rather than surveillance alone.
• High risk: PSA greater than 20, Gleason 8 to 10, or cancer that has spread locally.
• Very high or advanced risk: Cancer that has spread beyond nearby tissues or to distant sites.

These categories help determine whether a man may be a candidate for active surveillance or if more aggressive treatment is required.

Treatment options

Once staging and risk are determined, treatment decisions are made based on disease characteristics, patient age, other medical conditions, and personal preferences. Broadly, treatment for prostate cancer includes surgery, radiation, hormone therapy, or a combination of these.

Surgery

Radical prostatectomy is the surgical removal of the prostate gland and surrounding tissue. It can be performed using open surgery or minimally invasive robotic-assisted techniques. Surgery is most commonly offered to men with localized disease who are otherwise healthy. The primary goal is complete removal of the cancer, but risks include urinary incontinence and erectile dysfunction, which should be carefully discussed before treatment.

Radiation therapy

Radiation therapy uses targeted high-energy beams to kill cancer cells. There are two main approaches:

• External beam radiation therapy (EBRT): Radiation delivered from outside the body, often over several weeks.
• Brachytherapy: Placement of radioactive seeds directly into the prostate.

Radiation can be as effective as surgery for many men with localized prostate cancer and may be combined with hormone therapy for higher-risk disease. Side effects can include urinary frequency, bowel changes, and erectile dysfunction, though advances in targeting have reduced these complications.

Stereotactic Body Radiation Therapy (SBRT) and the CyberKnife

A newer form of external beam radiation, Stereotactic Body Radiation Therapy (SBRT), allows for highly precise delivery of radiation in just a few treatments, typically five sessions or fewer. SBRT uses advanced imaging and motion tracking to account for the prostate’s natural movement, ensuring accuracy and reducing exposure to surrounding tissues like the bladder and rectum.

At Ascension Via Christi, we use the CyberKnife® system for SBRT in prostate cancer. 

CyberKnife’s robotic arm delivers radiation from multiple angles while adjusting in real time to the prostate’s position. This precision minimizes side effects and provides excellent cancer control outcomes comparable to longer courses of EBRT.

Many patients appreciate the convenience of SBRT, as it shortens treatment time from several weeks to a few days, while maintaining effectiveness. For select men with localized prostate cancer, SBRT with CyberKnife represents a safe, efficient, and patient-friendly option.

Hormone therapy

Prostate cancer cells depend on androgens, such as testosterone, to grow. Androgen deprivation therapy (ADT) reduces or blocks these hormones to slow cancer growth. This therapy is often used in men with advanced or high-risk cancer, either alone or combined with radiation.

ADT can be given by injections that lower testosterone production or by medications that block testosterone activity. While highly effective, long-term hormone therapy carries side effects such as weight gain, bone thinning, hot flashes, fatigue, and loss of sexual function.

Combination approaches

In many cases, treatments are combined. For example, men with intermediate or high-risk localized cancer may receive radiation plus hormone therapy. Men with advanced disease may benefit from newer therapies such as androgen receptor inhibitors, chemotherapy, or targeted therapies guided by genetic testing.

Living with a diagnosis

Beyond treatment, living with prostate cancer also means managing its emotional and physical effects. Many men experience anxiety when facing decisions about treatment, especially since different approaches can offer similar survival outcomes but vary in their side effects.

It is important to have open conversations with your healthcare team, seek second opinions if needed, and involve loved ones in the decision-making process. Support groups and counseling can provide additional reassurance.

Cancer care that listens

Prostate cancer is a common diagnosis, but it is also a highly treatable one. Understanding the stage of disease, Gleason score, and risk category provides a foundation for making informed choices about surgery, radiation, and hormone therapy. With early detection, survival rates are excellent, and even advanced cases benefit from a growing range of effective treatments.

A diagnosis of prostate cancer does not mean facing the journey alone. By engaging with your medical team, educating yourself, and accessing support, you can take an active role in your care and move forward with clarity and confidence.

Learn more about prostate cancer treatment from radiation oncologists at the Via Christi Cancer Center in Wichita, Kansas, call (316) 268-5927.