The tumor extends to more than 5 percent of the tissue removed at surgery and is usually medium to high grade. It is a dangerous tumor, and 34 percent of patients have unexpected spread to lymph nodes when the tumor is found.
Standard Treatment Removal of the pelvic lymph nodes, followed by radical prostatectomy during the same operation if the lymph nodes are found to be negative. If the tumor location and tissue conditions permit, nerve-sparing methods may be used to preserve sexual ability.
Postoperative radiation therapy should be considered if the tumor is found to invade or penetrate the prostate capsule or if serum PSA levels remain elevated three weeks after surgery.
• External beam radiation therapy using the linear accelerator .
• Careful observation or hormonal therapy may be acceptable in patients with other serious medical problems
that might indicate a short life expectancy or an inability to withstand the stress of surgery or radiation.
