Introduction to Advanced Prostate Cancer (Royal Stage) | Prostate Cancer Staging Guide

PCRI’s Executive Director, Mark Scholz, MD, gives an overview of the Royal stage of prostate cancer and its five subdivisions.

0:23 Unlike the other four stages of prostate cancer (Sky, Teal, Indigo, and Azure) which all have three subdivisions, Royal stage prostate cancer has five total subdivisions.

1:17 Royal stage prostate cancer is defined by one of two characteristics (or both): Either a man’s prostate cancer has become castration-resistant (that is, the cancer is no longer responding to hormone treatment) and/or metastatic disease has spread beyond the pelvic lymph nodes. Royal stage prostate cancer is a serious situation and requires aggressive management of the disease.

2:21 The Low-Royal stage is a situation where prostate cancer has developed a resistance to hormone treatment, but without any spread beyond the pelvic lymph nodes. It is usually discovered when a man’s PSA begins to rise while on hormone treatment.

3:13 Basic and High-Royal are both defined by situations in which there are metastases outside the pelvic region. Basic-Royal is when there are five or fewer metastases and High-Royal is when there are six or more metastases outside the pelvic region.

4:00 Basic and High-Royal are each sub-divided to include situations in which a man without prior treatment has metastases outside the pelvic region but is hormone-sensitive (the opposite of castration-resistant). This situation occurs when a man forgoes screening and the disease spreads undiscovered beyond the pelvic region. There is no category for hormone-sensitive Low-Royal since the category is defined only by castration resistance. In summary, there is Low-Royal, hormone-sensitive Basic-Royal, castration-resistant Basic-Royal, hormone-sensitive High-Royal, and castration-resistant High-Royal.

4:43 Royal stage prostate cancer is much less predictable than the cancers defined by the other four stages. Achieving remission is possible, but it is not a foregone conclusion as with other stages, and so monitoring the disease with scans and blood tests is very important.

Don’t know your stage? Take the quiz: Visit http://www.prostatecancerstaging.org

To learn more about prostate cancer visit http://www.pcri.org

To download the free Staging Guide visit http://www.pcri.org/prostate-cancer-s...

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