However, if the tumor extends through the capsule, surgery is not recommended and radiation therapy is usually advised.
Hormonal therapy is preferred when the cancer spread to other parts of the body.
Tumor spread outside the prostatic capsule has traditionally been detected by the examiner's finger during rectal exam. MRI has attempted to improve the accuracy of those findings. In order to best evaluate the prostate, MRI is performed with a special surface coil that is placed into the rectum during the exam. This rectal coil greatly improves the sensitivity of the study when compared to traditional imaging with the body coil. However, at the conclusion of the study, images of the abdomen and pelvis with the body coil are performed in order to detect any enlarged lymph nodes that might represent distant spread of tumor.