Here’s a clear summary of prostate cancer treatments by stage.

Stage I – Early / Very Low Risk

Cancer is small, confined to the prostate, and often slow-growing.
Typical options:

• Active surveillance (watchful waiting) – most common

• Surgery (radical prostatectomy) – if patient is younger or prefers active treatment

• Radiation therapy – an alternative to surgery

Stage II – Localized (Still in the Prostate)

Tumor is larger but still confined within the prostate.
Typical options:

• Surgery (robotic or open prostatectomy)

• External beam radiation or brachytherapy

• Hormone therapy may be added to radiation in some cases

• Active surveillance is still possible for low-risk cases

Stage III – Locally Advanced

Cancer has spread just outside the prostate (e.g., to the seminal vesicles) but not to lymph nodes or distant organs.
Typical options:

• Radiation therapy + hormone therapy (combination)

• Surgery (in select cases) followed by radiation if needed

Stage IV – Advanced / Metastatic

Cancer has spread to lymph nodes, bones, or other organs.
Typical options:

• Hormone therapy (ADT) – first-line treatment

• Chemotherapy (e.g., docetaxel)

• Targeted therapy (e.g., PARP inhibitors for BRCA mutations)

• Immunotherapy (e.g., sipuleucel-T, pembrolizumab)

• Radiation for symptom relief (e.g., bone pain)

Recurrent or Resistant Prostate Cancer

If the cancer returns or becomes resistant to hormone therapy:

• Next-generation hormone blockers (enzalutamide, abiraterone)

• Chemotherapy or targeted therapy

• Clinical trials for novel treatments