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Stages of Prostate Cancer

Your prostate cancer prognosis is dependent upon the extent the cancer has spread to other areas of your body. Doctors classify the progression of prostate and other cancers using a staging process. Not only do the stages of prostate cancer describe the spread of the disease, but they are also an indication of the probability of being cured by therapies such as surgery or radiation.  Prostate cancer is staged using the TNM system—tumor, nodes, metastasis. Doctors use the size of the tumor, the involvement of the lymph nodes, any metastasis, and the grade of the cancer, to group the cancer into one of four stages (I–IV).

Stage I

Stage I prostate cancer is strictly located in the prostate only and the prostate-specific antigen (PSA) score is <10. Stage I prostate cancer cannot be felt during an exam, cannot be seen in an image of the prostate, and the cells closely resemble normal cells. A Stage 1 tumor involves less than 1/2 of the prostate.

Stage II

In Stage II, the cancer has grown within the prostate and can be felt in an exam, but has not extended beyond the prostate. PSA scores are higher and much more of the prostate is involved.

Stage III

Stage III marks the point when the cancer begins to spread outside the prostate. In this stage, the cancer can also be found in surrounding tissues, but has not spread to the lymph nodes or any other major organs.

Stage IV

In Stage IV, the cancer has spread far and wide from the prostate and invaded nearby structures such as the bladder or the rectum, or moved to the lymph nodes, bones, or other major organs such as the lungs or the liver.

Prostate cancer stages are used by physicians and caregivers to determine optimal treatment regimens. Extensive testing is used to determine the stage. Your doctor will work with you to determine which tests are necessary. Tests to diagnose and stage prostate cancer include the following:

  • Manual rectal exam
  • PSA test
  • Transrectal ultrasound
  • Prostate MRI done with a rectal probe
  • CT scan of the pelvis and abdomen that looks for cancer in other regions
  • Full MRI of the skeleton
  • Nuclear medicine bone scan
  • Surgery to examine the lymph nodes in the pelvis for any prostate cancer spread

If you have questions about your cancer and its progression, talk to your doctors at the Prostate Cancer Institute. They’ll work with you to help you understand your cancer and your treatment options.

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