Hearing you have prostate cancer can understandably cause stress and anxiety. However, a Stage 1 diagnosis is highly manageable. Early-stage prostate cancer has a five-year survival rate of nearly 100% and a ten-year survival rate of 98%.
This is because Stage 1 prostate cancer grows slowly and is considered low risk. Most physicians do not recommend immediate treatment, meaning you have time to explore your options and decide what is best for you.
Still, even though it is low risk, it is important to stay informed. Knowing what to expect helps you keep track of any changes and act quickly if the cancer grows.
This guide provides a comprehensive overview of Stage 1 prostate cancer, including symptoms, prognosis, and treatment options, to help you make informed decisions about your diagnosis.
What Is Stage 1 Prostate Cancer?
Stage 1 prostate cancer is localized to the prostate gland and classified as low risk due to its slow growth. Most men have no symptoms at the time of diagnosis.
Under the TNM staging system, Stage 1 prostate cancer is defined by the following features:
- T1 or T2a: The tumour is confined to the prostate and involves one-half or less of a single lobe, or is not detectable on imaging or physical examination
- N0: The cancer has not spread to nearby lymph nodes
- M0: The cancer has not spread to distant parts of the body
- Grade Group 1: Gleason score of 6 (3+3)
- PSA level: Below 10 ng/mL
As the lowest-risk category of prostate cancer, Stage 1 disease often does not require immediate treatment. Its slow-growing nature means active surveillance is commonly recommended over more aggressive approaches.
How Prostate Cancer Stage 1 Is Diagnosed
Because Stage 1 prostate cancer often causes no symptoms, it is most commonly detected through routine screening. This typically begins with a PSA blood test and a digital rectal exam (DRE).
But abnormal screening results alone do not confirm prostate cancer. If cancer is suspected, a biopsy is performed to confirm the diagnosis and determine the Gleason score, which reflects how aggressive the prostate cancer cells appear.
Doctors look at all these results together to confirm the stage of the cancer. They use PSA levels, biopsy results, physical exams, and sometimes imaging tests to see if the cancer is only in the prostate and fits the Stage 1 criteria.
Stage 1 Prostate Cancer Symptoms
Most men with Stage 1 prostate cancer experience no noticeable symptoms.
When symptoms do occur, they are usually mild and non-specific and may resemble those of benign prostatic hyperplasia (BPH), including:
- Increased urinary frequency
- Difficulty starting or maintaining urine flow
- Weak urine stream
- Mild discomfort during urination
- Occasional pelvic discomfort
Because these symptoms are common in non-cancerous prostate conditions, they are not a reliable indicator of prostate cancer or its stage on their own.
Stage 1 Prostate Cancer Treatment Options
Because Stage 1 prostate cancer is localized and low risk, patients usually have several management options. Immediate treatment is not always necessary, and decisions are guided by disease characteristics, overall health, and quality-of-life considerations.
The most common management approaches for Stage 1 prostate cancer include:
Active Surveillance for Stage 1 Prostate Cancer
Many men with Stage 1 prostate cancer never experience progression or life-threatening disease. In these cases, immediate intervention is often unnecessary and may expose patients to avoidable risks such as incontinence and impotence.
For these reasons, active surveillance is often the first-line approach, involving regular PSA tests, imaging, and occasional biopsies.
Active treatment is only initiated if there are clear signs of disease progression, helping patients maintain quality of life without compromising long-term outcomes.
Non-Thermal Focal Therapies for Stage 1 Prostate Cancer
For men who prefer not to rely solely on active surveillance, non-thermal focal therapies such as irreversible electroporation (IRE) and photodynamic therapy (PDT) offer minimally invasive treatment options.
These therapies treat only the cancerous portion of the prostate rather than the entire gland. By limiting treatment to the affected area, focal therapy reduces the risk of side effects commonly associated with whole-gland treatments such as prostatectomy and radiation therapy.
Unlike thermal focal treatments such as HIFU and cryotherapy, IRE and PDT do not rely on extreme heat or freezing to destroy tissue. This minimizes damage to surrounding structures, which helps preserve urinary continence and sexual function in patients with localized disease.
Surgery and Radiation for Stage 1 Prostate Cancer
Radical prostatectomy and radiation therapy are definitive treatment options and are still commonly recommended for Stage 1 prostate cancer. However, for localized, low-risk disease, these approaches often involve treating more tissue than necessary.
Radical prostatectomy involves removing the entire prostate and carries a known risk of urinary incontinence and erectile dysfunction due to possible damage to surrounding nerves and structures. Radiation therapy, though non-surgical, exposes healthy tissue to radiation and carries similar long-term risks.
Given the slow-growing nature of Stage 1 prostate cancer, surgery and radiation often exceed what is necessary for disease control. These options are typically considered when patients prefer immediate definitive treatment or have clinical factors that justify a whole-gland approach.
Choosing the Right Treatment for Stage 1 Prostate Cancer
The most important thing to understand is that prostate cancer typically develops slowly. In Stage 1, patients usually have time to carefully evaluate their options, and in many cases, the cancer may never progress to a life-threatening stage.
When considering which approach is the best fit, key factors include:
- Age and overall health
- Tumour location and extent
- Comfort with ongoing monitoring versus active treatment
- Quality-of-life priorities, including urinary and sexual function
Patients should not feel pressured into immediate treatment. Taking the time to understand all available options, including seeking a second opinion, is an important part of informed decision-making.
For more information about Stage 1 prostate cancer management and treatment options, you can speak with the team at VITUS Privatklinik.
Stage 1 Prostate Cancer Prognosis and Survival Rate
Stage 1 prostate cancer has an excellent long-term prognosis. The disease is localized and typically slow-growing, with many cases remaining stable for years without intervention.
Survival rates reflect this outlook. Five-year survival for Stage 1 prostate cancer is nearly 100%, and the vast majority of patients will not die from the disease.
Recurrence is possible over long periods, but rates for low-risk Stage 1 prostate cancer are low. Data from the Johns Hopkins Medicine Han Tables, which estimate biochemical recurrence after radical prostatectomy, show:
- 3 years after surgery: approximately 0–2%
- 5 years after surgery: approximately 1–4%
- 7 years after surgery: approximately 1–5%
- 10 years after surgery: approximately 1–7%
Published outcomes from 471 patients treated with irreversible electroporation (IRE), with follow-up of up to 70 months, show recurrence patterns that align with ranges reported in the Johns Hopkins Medicine Han Tables for comparable risk profiles.
Life After a Stage 1 Prostate Cancer Diagnosis
A Stage 1 prostate cancer diagnosis can be unsettling, but most men continue to live normally while considering their options. Because the disease is usually slow-growing, patients often have time to monitor their condition or pursue treatment without disrupting daily life.
With appropriate management, urinary and sexual function can often be preserved. Ongoing follow-up provides reassurance and enables early detection of any changes. Staying informed allows patients to remain proactive without unnecessary anxiety.
If you would like to discuss your diagnosis or explore your options in more detail, contact our care team to learn more about personalized management for Stage 1 prostate cancer.
Frequently Asked Questions About Stage 1 Prostate Cancer
Yes. Stage 1 prostate cancer is highly curable when detected early. Many men with Stage 1 disease never experience progression or life-threatening illness, and long-term survival rates are excellent.
Stage 1 prostate cancer is confined to the prostate and has not spread to lymph nodes or distant organs. At this stage, the risk of spread is very low. With appropriate monitoring, signs of progression are usually detected early, before spread occurs.
Stage 1 prostate cancer usually grows very slowly. Many cases remain stable for years without significant change. This slow growth is why active surveillance is often recommended and why patients have time to evaluate their management options.
No. Many men with Stage 1 prostate cancer do not require immediate treatment. Active surveillance is often appropriate and allows patients to avoid unnecessary side effects while maintaining close monitoring. Treatment is reserved for cases where there are signs of progression or when patient-specific factors justify intervention.
Recurrence is possible, but rates for low-risk Stage 1 prostate cancer are low. When recurrence occurs, it is often detected early through routine follow-up. Early detection allows for timely management, and long-term outcomes remain favourable for most patients.
- American Joint Committee on Cancer (AJCC).
AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017. - National Comprehensive Cancer Network (NCCN).
NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer. Current version.
https://www.nccn.org. Accessed March 2026. - Johns Hopkins Medicine.
Prostate Cancer Prognosis.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-prognosis. Accessed March 2026. - Johns Hopkins Brady Urological Institute.
Han Tables: Prostate Cancer Risk Assessment Tools.
https://www.hopkinsmedicine.org/brady-urology-institute/conditions-and-treatments/prostate-cancer/risk-assessment-tools/han-tables. Accessed March 2026. - Valerio M, Dickinson L, Ali A, et al.
A prospective development study investigating focal irreversible electroporation for localized prostate cancer: Oncological and functional outcomes. European Urology. 2019;76(3):303–311.
https://pubmed.ncbi.nlm.nih.gov/30986263/. Accessed March 2026.