The TNM method of staging cancer, which is commonly used to stage malignancies that produce tumours, is utilised to stage prostate cancer. Prostate cancer is staged using two additional parameters: PSA levels and grade (based on the Gleason score).

Stage IV prostate cancer

Stage IV prostate cancer is a severely advanced stage in which cancer has migrated to the lymph nodes and distant organs such as the liver, bones, and lungs. It can be broken down into the following stages:

Stage IVA:

Cancer has progressed to surrounding tissues and lymph nodes but not to distant organs at this point. Any T, N1, M0, Any Grade Group, and any PSA levels are staged.

Stage IVB:

These cancers have extended beyond the prostate to the nearby tissues, distant lymph nodes and other organs. Any T, all N, M1, Any Grade Group, and any PSA levels are staged.

What is the treatment for stage IV prostate cancer?

The following are some of the therapy options for stage IV prostate cancer:

  • In addition to chemotherapy, hormone treatment is used.
  • Hormone treatment and external beam radiation
  • If cancer has not progressed to the lymph nodes, a radical prostatectomy is recommended.
  • Surgery to relieve symptoms
  • Active surveillance
  • Clinical trials

External beam radiation:

It is a sort of radiation therapy that involves the use of high-energy X-ray beams to eliminate malignant cells. External beam radiation therapy, also known as EBRT, uses a machine outside the body to focus radiation beams on the prostate gland, which is used to treat cancer in its early stages.


Brachytherapy is a sort of radiation therapy in its own right. Small radioactive pellets the size of a grain of rice are implanted directly inside the prostate gland, a procedure known as seed implantation or interstitial radiation therapy. This treatment is used alone in people with cancer that is in its early stages and is growing slowly. Otherwise, it is preferable to use this in conjunction with other therapeutic options.

Hormone treatment

Hormone treatment for prostate cancer is used when cancer has spread too far for radiation or surgery to be effective, or when the cancer is at a danger of recurrence, or to shrink the malignancy before radiation therapy. This medication, also known as androgen deprivation therapy or androgen suppression therapy, tries to lower the levels of androgens, male hormones that encourage prostate growth in humans. Hormone therapy can decrease the tumour or slow its progression, but it is not a cure for prostate cancer.

Active surveillance

Active surveillance is a method of closely monitoring the malignancy on a regular basis. Once every six months or so, a PSA blood test, DRE (digital rectal examination), and prostate biopsies may be performed. If the results indicate that the disease is spreading, different therapeutic options for eradicating the malignancy are considered. Only if the patient is too elderly or unable to tolerate the treatment's adverse effects, or if the patient has major complications or illnesses that impede treatment of prostate cancer, is it considered a treatment option in the later stages.


Chemotherapy is a type of treatment that employs medications to kill cancer cells all over the body. It is used when prostate cancer has progressed beyond the prostate gland or if there is a risk of recurrence. It is not a routine treatment for this cancer type, although it is used when hormone therapy fails. To allow the body to recuperate and limit the severity of side effects, the treatment is administered in cycles of medication and rest.