Stage 3 prostate cancer has a 5-year survival rate of approximately 80-90%.
About 26% of men diagnosed with prostate cancer in New Zealand fall into the high-risk group, which includes Stage 3.
In 2021, approximately 46% of men with high-risk prostate cancer in New Zealand received surgery as their primary treatment.
Stage 3 prostate cancer means the cancer has spread beyond the prostate but has not yet reached distant parts of the body. At this stage:
- The cancer has extended beyond the outer layer of the prostate
- It may have spread to the seminal vesicles (glands that help produce semen)
- PSA levels are typically above 20 ng/mL
- The Gleason score is usually 7-10
Stage 3 is considered "locally advanced" and typically falls into the "high-risk" category. In New Zealand, approximately 26% of men diagnosed with prostate cancer are classified as high-risk.
High-risk prostate cancer requires more aggressive treatment approaches than earlier stages, but still has good outcomes with proper treatment.
Understanding Stage 3 Prostate Cancer from a Māori Perspective
Stage 3 prostate cancer presents significant challenges for Māori men, who are often diagnosed at more advanced stages compared to non-Māori. Research from Te Aho o Te Kahu (Cancer Control Agency) indicates Māori men have a 70% higher mortality rate from prostate cancer, despite similar overall incidence rates, largely due to later diagnosis and treatment barriers.
Intensive Treatment Journey and Cultural Wellbeing
Stage 3 prostate cancer typically requires more aggressive treatment approaches. For Māori men, maintaining cultural connections during this intensive treatment period is vital:
- Consider how treatment schedules might impact participation in cultural events and responsibilities
- Discuss with healthcare providers how to accommodate important cultural ceremonies or gatherings
- Maintain connection to whenua (land) and whakapapa (genealogy) as sources of strength
- Engage with kaumātua or cultural advisors who can provide spiritual guidance during treatment
Extended Whānau Support Systems
The concept of whanaungatanga (kinship and connectedness) becomes especially important during Stage 3 treatment. Consider:
- Organising a whānau hui to discuss treatment plans and distribute support responsibilities
- Identifying specific whānau members to assist with different aspects of care (transportation, meals, home support)
- Creating a roster system for accompanying you to treatments and appointments
- Establishing clear communication channels to keep extended whānau informed of progress
- Discussing with healthcare providers how whānau can be meaningfully involved in care decisions
Navigating Complex Treatments
Stage a 3 treatments are more complex and may include combinations of surgery, radiation, and hormone therapy. To navigate this effectively:
- Request a Māori health navigator (kaiāwhina) through your DHB to help coordinate care
- Ask for treatment information that acknowledges Māori perspectives on health and wellbeing
- Discuss with your oncologist how treatments might be modified to reduce impact on cultural responsibilities
- Inquire about supportive care that incorporates Māori healing traditions alongside medical treatments
Side Effect Management with Traditional Approaches
Managing side effects may incorporate traditional practices alongside medical management:
- Rongoā practitioners may suggest specific plant medicines like kawakawa to help with inflammation (always discuss with your medical team first)
- Traditional mirimiri (massage) may help with muscle tension and relaxation
- Karakia (prayer) and waiata (song) can provide spiritual comfort and stress reduction
- Connection with wai (water) through ocean or river bathing may provide both physical and spiritual benefits
Advanced Support Services for Māori
Several organisations provide specialised support for Māori men with advanced prostate cancer:
- Te Aho o Te Kahu: Offers resources specifically for Māori patients with advanced cancer
- Local Māori Health Providers: Can provide holistic support during treatment
- Hospice services increasingly incorporate cultural elements for Māori patients requiring palliative care support
Financial and Practical Support
Advanced cancer treatment often brings financial challenges. Support available includes:
- Work and Income support payments (some with specific provisions for serious illness)
- Māori social service agencies that can assist with practical support
- National Travel Assistance for those traveling to treatment centers
- Whānau Ora navigators who can help access appropriate support services
"He iti hau marangai e tū te pāhokahoka."
After the storm, the rainbow stands.
This whakatauki reminds us that even through the difficulties of Stage 3 prostate cancer treatment, there is hope. The journey may be challenging, but with proper medical care, cultural support, and whānau around you, positive outcomes are still achievable for many men with locally advanced prostate cancer.
Based on New Zealand patient data, there are several treatment approaches for Stage 3 prostate cancer:
Radical Prostatectomy
Surgical removal of the prostate is a common treatment for Stage 3 cancer in New Zealand, with approximately 46% of high-risk patients choosing this option. This approach is particularly common in younger patients, with around 79% of high-risk patients under 60 receiving surgery, compared to only 14% of those over 75.
- May be followed by additional treatments if cancer is found at surgical margins
- Often combined with lymph node removal
- Available at major hospitals throughout New Zealand
Radiation Therapy with Hormone Therapy
Combined radiation and hormone therapy is used for many high-risk patients, especially older men. About 13% of high-risk patients under 60 and 38% of those over 75 receive this combined treatment. This usually involves:
- External beam radiation therapy targeting the prostate and surrounding areas
- Hormone therapy (androgen deprivation therapy or ADT) for 18-36 months
- Treatment is available through regional cancer centers like the Canterbury Regional Cancer and Haematology Service
Radiation Therapy Alone
About 12% of high-risk patients receive radiation therapy without hormone therapy, with this approach being more common in older patients (12% of those over 75 compared to 4% of those under 60).
Hormone Therapy (ADT)
Hormone therapy alone is used in approximately 23% of high-risk patients, particularly older men. This may include:
- LHRH agonists/antagonists like Goserelin
- Anti-androgens like Bicalutamide
- Newer generation hormone therapies like Abiraterone
The drugs are typically administered as injections every 1-3 months at cancer centers or by GPs.
Based on data from New Zealand patients one year after treatment, here are common side effects for different treatments:
Surgery Side Effects
- Urinary issues: 31% needed more than one urinary pad per day, 20% experienced more than one urinary leak per day
- Sexual function: 45% reported sexual function as a problem, only 22% reported having fair to very good erections
- Other effects: 10% reported feeling depressed, 13% reported lack of energy
Radiation Therapy with Hormone Therapy Side Effects
- Bowel function: 9% reported bowel habits as a problem
- Sexual function: 37% reported sexual function as a problem, only 12% reported having fair to very good erections
- Energy levels: 31% reported lack of energy
- Emotional effects: 12% reported feeling depressed
Hormone Therapy Side Effects
- Hot flashes and night sweats
- Fatigue (33% report lack of energy)
- Sexual dysfunction (30% report sexual function as a problem)
- Loss of bone density
- Changes in body composition
- Emotional changes (12% report feeling depressed)
The Canterbury Regional Cancer and Haematology Service and other cancer centers in New Zealand provide comprehensive support for managing these side effects, including:
- Medications for specific side effects
- Access to dietitians, psychologists, and social workers
- Specialist nursing support
- Referrals to support groups
New Zealand offers various support services for Stage 3 prostate cancer patients:
- Cancer Society New Zealand: Located on many hospital campuses with information resources and support services. They can assist in arranging accommodation for those traveling for treatment.
- Prostate Cancer Foundation NZ: Provides support groups throughout New Zealand with regular meetings for patients and families
- District Health Board Services: Including:
- Dietitians - to assist with nutrition during treatment
- Social Workers - for psychosocial support and financial assistance
- Occupational Therapists - to help keep independence
- Physiotherapists - to assist with physical function
- Speech Language Therapists - for any swallowing difficulties
- Cancer Psychological and Social Support Service - specialist support
- Pharmacists - medication management experts
- Financial Support: Work and Income New Zealand (0800 559 009) may provide financial assistance for those unable to work
- Travel Assistance: The National Travel Assistance programme helps with travel and accommodation costs for those who need to travel for treatment
For immediate concerns during treatment, you can contact the oncology department at (03) 364 0020 to speak with a nurse 24 hours a day.
During Treatment
While undergoing treatment for Stage 3 prostate cancer:
- Continue normal activities as much as you feel able
- Maintain good nutrition - a dietitian can provide guidance
- Stay hydrated - drink plenty of fluids
- Report any unusual symptoms to your care team
- Keep track of appointments and medications
- Involve family members or friends in your care
After Treatment
Follow-up care is important:
- Regular PSA testing to monitor for recurrence
- Scheduled check-ups with your oncology team
- Continue general health care with your GP
- Report any new symptoms promptly
- Consider joining a support group. You can find them here
Practical Considerations
- Driving: In most cases, you can drive to and from treatment appointments, but it's helpful to bring someone to your first appointment
- Diet: No special dietary changes are required during treatment, but maintaining good nutrition is important
- Exercise: Any amount of activity, no matter how small, can help you regain strength
- Medications: Bring a list of all medications to your appointments, including complementary medicines
- Dental care: Maintain good oral health, but discuss timing of dental work with your oncology team
Reliable New Zealand-specific resources for Stage 3 prostate cancer:
- Ministry of Health
- Canterbury Regional Cancer and Haematology Service
- Cancer Society of New Zealand
- Prostate Cancer Foundation NZ
- HealthInfo - For Canterbury-specific health information
For concerns about treatment side effects, contact your oncology team at any time by telephoning (03) 364 0020 (Canterbury) or your local cancer center.
Contact the Oncology Service immediately (24 hours) if:
- You begin to feel unwell or are unexpectedly unwell
- You start to feel muddled or confused
- Your temperature is 38°C or more
- Your temperature is less than 35.5°C
- You have uncontrolled shaking or shivering
- You have large and/or frequent diarrhoea/loose bowel motions
- You have chest heaviness/tightness or chest pain
- You notice any bleeding
- You have sensory changes that are worsening
You can reach the Canterbury Regional Cancer and Haematology Service at (03) 364 0020 to speak with a nurse 24 hours a day. Similar services are available at other regional cancer centers.