Staging Advanced Prostate Cancer

Health Writer

Staging cancer, including advanced prostate cancer, is a way of determining whether cancer has spread from it’s original location and if so, how far it has spread. This helps your doctor provide recommendations for the best possible treatment.

TNM classifications

For advanced prostate cancer, like many other types of cancer, doctors often use the TNM system as the first step in staging. TNM stands for tumor, nodes and metastases.

T - Tumor

The staging for tumors can range from T1 to T4 and is based on the size of the tumor as well as whether the tumor has spread.

T1 indicated that the tumors are within the prostate gland and can’t be detected through a physical examination. At this point, the cancer was probably detected with a raised PSA score and possibly a needle biopsy.

T2 has several subcategories but all indicate that the tumor is still located within the prostate and has not spread to other areas of the body.

T3 indicates that the tumor has broken through the covering of the prostate but may or may not have spread to other parts of the body.

T4 tumors have spread to other body organs near the prostate such as the bladder, muscles, sides of the pelvic cavity or rectum.

N- Nodes

There are three classifications based on whether the cancer has spread to the lymph nodes:

NX - The lymph nodes cannot be checked

N0 - The lymph nodes close to the prostate do not have any cancer cells

N1 - Cancer has spread to the lymph nodes

M - Metastases

This classification is given when cancer has spread. M0 indicates that cancer has not spread outside of the pelvic cavity. M1 indicates that cancer has spread outside of the pelvic cavity. The subcategories indicate where the cancer has spread:

M1a - lymph nodes

M1b - bone

M1c - other places in the body

Stage group

The next part of the staging process is to use the information from the TNM categorization and take the Gleason score and the results of the prostate-specific antigen (PSA) test. These tests were probably completed at the initial diagnosis but can be repeated if necessary. Staging for prostate cancer, as with other forms of cancer, range from Stage I to Stage IV.

  • Stage I - Cancer has not spread outside the prostate, PSA level is less than 10
  • Stage II - Cancer has not spread to the lymph nodes and PSA levels are usually higher than in Stage I
  • Stage III - Cancer has spread to tissue near the prostate but has not spread to the lymph nodes or other parts of the body
  • Stage IV - Cancer has spread to lymph nodes, other organs or tissues near the prostate

Staging for prostate cancer can be confusing and complex because it involves the Gleason score, PSA scores, TNM and stage groups. While early diagnosis is always important, according to the American Cancer Society, anyone diagnosed with prostate cancer has a good chance of survival:

  • 5 year survival rate - 100 percent
  • 10 year survival rate - 99 percent
  • 15 year survival rate - 94 percent

Despite the good prognosis for those diagnosed with prostate cancer, doctors still recommend that men are regularly screened. The age screening should begin depends on your risk factors. You should talk with your doctor about what is best for you.

For more information on Advanced Prostate Cancer: Current Treatments for Metastatic Prostate Cancer Prostate Cancer and Erectile Dysfunction Prostate Cancer Treatment Options: Medical Castration - Antagonist vs Agonist

References: How is Prostate Cancer Staged?: American Cancer Society The Stages of Prostate Cancer: Cancer Research UK