Local prostate cancer refers to disease that is confined to the prostate. This conclusion is reached according to the results of the imaging and digital rectal examination findings before and after the biopsy. Local prostate cancer includes all diseases that do not exceed the capsule, do not involve lymph stations and do not spread to distant organs. Locally advanced or metastatic (spreading to the body) disease means cancer that has spread beyond the organ locally to neighboring organs or distant organs.
The local stage of prostate cancer is also divided into three as low, intermediate and high risk groups. It is stated in the guidelines that some different treatment modalities can be applied in these groups. These groups were formed according to the different recurrence rates after the treatments.
Locally advanced disease, on the other hand, can be felt on physical examination when the prostate has exceeded its capsule. In addition, with a highly sensitive method such as multiparametric prostate MRI, where the planes can be seen clearly, an opinion can be obtained about capsular excess, neighboring organ spread, and the preservation of the vessel-nerve package. Involvement of lymph stations in the pelvic region in imaging also puts it in the group of locally advanced diseases.
Metastatic disease refers to the involvement of non-pelvic lymph nodes, bone, or other distant organs with prostate cancer. This diagnosis can be made with bone scintigraphy, MRI or PSMA-PET-CT.