classify patients who have progressed after hormonal therapy as stage D3. On the basis of men diagnosed with prostate cancer at Walter Reed Army Medical Center from 1988 to 1998, including over 2,042 prostate cancer diagnoses, localized prostate cancer (stage Ti and T2) was diagnosed more frequently (89% versus 68%), and advanced disease (stages T3, T4, and D) was diagnosed less frequently (11% versus 32%) when comparing the incidence rates in 1998 to the 1988 rates31.

Clinical Presentation of Prostate Cancer Localized Disease

Asymptomatic Locally Invasive Disease

Ureteral dysfunction, frequency, hesitancy, and dribbling Impotence

Advanced Disease

Back pain

Cord compression

Lower extremity edema

Pathologic fractures


Weight loss

Table 92-3 Diagnostic and Staging and Classification Systems Workup for Prostate Cancer

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