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Prostate Cancer Stages

 When prostate cancer is diagnosed, it is given a stage and a grade.

Staging is determining the extent of the cancer, if it has spread to other parts of the body. It is different than grading. (A page on grading is at this site.)

Two popular systems for staging Prostate Cancer are presented on this page.

The Whitmore-Jewett staging ranges from A to D with sub-stages for more precise definition. The TNM staging system describes the extent of the primary tumor (T), the absence or presence of metastasis to nearby lymph nodes or glands (N), and the absence or presence of distant metastasis (M).

(For a simpler view of the TNM stages, with diagrams, click here.) 		 
 

STAGE SUB-STAGE DEFINITION
T1   Clinically unapparent tumor, not detected by DRE nor visible by imaging
  T1a Incidental histologic finding; <5% of tissue resected during TURP
  T1b Incidental histologic finding; >5% of tissue resected during TURP
  T1c Tumor identified by needle biopsy due to elevated PSA
T2   Confined within the prostate (detectable by DRE, not visible on TRUS)
  T2a Tumor involves half of the lobe or less
  T2b Tumor involves more than one half of one lobe but not both lobes
  T2c Tumor involves both lobes
T3   Tumor extends through the prostate capsule but has not spread to other organs
  T3a Unilateral extracapsular extension
  T3b Bilateral extracapsular extension
  T3c Tumor invades seminal vesicle(s)
T4   Tumor is fixed or invades adjacent structures other than seminal vesicles
  T4a Tumor invades bladder neck and/or external sphincter and/or rectum
  T4b Tumor invades levator muscles and/or is fixed to pelvic wall

STAGE SUB-STAGE DEFINITION
Node (N)   Regional lymph nodes
  N0 No lymph nodes metastasis
  N1 Metastasis in single lymph node <2 cm in greatest dimension
  N2 Metastasis in single lymph node >2cm but <5 cm in greatest dimension, or multiple lymph nodes, none >5 cm
  N3 Metastasis in lymph node >5 cm in greatest dimension

STAGE SUB-STAGE DEFINITION
Metastasis   Systemic spread
  M0 No distant metastasis
  M1a Non-regional lymph node metastasis
  M1b Bone metastasis
     a) Axial skeleton only
     b) Extending to peripheral skeleton also
  M1c Metastasis at other sites

STAGE SUB-STAGE DEFINITION
Histopathologic   Differentiation
  GX Grade cannot be assessed
  G1 Well differentiated (slight anaplasia)
  G2 Moderately differentiated (moderate anaplasia)
  G3 Poorly differentiated or undifferentiated (marked anaplasia)
 
 
(For a simpler view of the TNM stages, with diagrams, click here.)

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Staging I-IV

(The following is from the CancerNet Dictionary at the National Cancer Institute.)

Stage I prostate cancer: Cancer that is only in the prostate gland, cannot be felt during a digital rectal examination, is not visible by imaging, and causes no symptoms. It is usually found accidentally or because a blood test showed an elevated prostate-specific antigen (PSA) level. Cancer cells may be found in only one area of the prostate or they may be found in many areas of the prostate. Similar to stage A in the Whitmore-Jewett staging system.

Stage II prostate cancer: Cancer that may be found by a needle biopsy done because a blood test showed elevated prostate-specific antigen (PSA); or cancer which may be felt in the prostate gland during a digital rectal examination, even though the cancer cells are found only in the prostate gland. Similar to stage B in the Whitmore-Jewett staging system.

Stage III prostate cancer: Cancer cells have spread outside the covering (capsule) of the prostate gland to tissues around the prostate but not to the lymph nodes. The glands that produce semen (the seminal vesicles) may have cancer cells in them. Similar to stage C in the Whitmore-Jewett staging system.

Stage IV prostate cancer: Cancer cells have spread (metastasized) to lymph nodes (near or far from the prostate gland) or to organs and tissues far away from the prostate such as the bone, liver, or lungs. Similar to stage D in the Whitmore-Jewett staging system.



 
 
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This information is provided for educational purposes only and does not replace or amend professional medical advice. Unless otherwise stated and credited, the content of Phoenix5 (P5) is by and the opinion of and copyright © 2000 Robert Vaughn Young. All Rights Reserved. P5 is at <http://www.phoenix5.org>. P5's policy regarding privacy and right to reprint are at <www.phoenix5.org/infopolicy.html>.