A malignant tumor that forms in the prostate gland of male reproductive system is called prostate cancer. It is made up of adenocarcinoma cells most of the time, which are cells that come from glandular tissue. Cancer cells are named in accordance with the organ where they originate, no matter where in the body they are found. Prostate cancer is the most seen kind of cancer which grows in men other than skin cancers, and the second leading cause of deaths from cancer in men. This cancer can be divided into four stages according to its severity.
How to Distinguish Prostate Cancer Stages
A standard way for a cancer care team to describe how far cancer has spread is by using a staging system. The American Joint Committee on Cancer or AJCC, TNM system is the most commonly used when it comes to distinguish prostate cancer stages.
1. Types of Staging
There are two types of staging, one being the clinical stage which is the best guess of your doctor of the extent of your disease which is based on the results of a physical exam, prostate biopsy, lab tests, and any kind of imaging tests you’ve had.
Your doctor can determine the pathologic stage if you have surgery, and this is based on the surgery and examination of the tissue removed. Therefore if you have surgery, the stage of your cancer may change after the fact, like if the cancer was found in a location not expected. Pathologic staging is most likely to be more accurate than clinical staging, since it lets your doctor get an impression firsthand of how bad your cancer is. This is just one advantage to having surgery instead of active surveillance or radiation therapy.
2. TNM System
There are five pieces of information which this system is based upon, including the PSA level at the time of your diagnosis, the extent of the primary tumor, whether or not the cancer has spread to nearby lymph nodes, the Gleason score which is based on prostate biopsy, and the presence or absence of distant metastasis.
Watch a video to know more about how to distinguish prostate cancer stages:
Prostate Cancer Stages
A way describing where the prostate cancer is located is called staging. The TNM system (T for tumor, N for node, and M for metastasis) is one particular tool that doctors use to describe prostate cancer stage. These 3 factors are what doctors look at to figure out the stage of the cancer.
|
Stages |
Description of the Cancer |
|
|
Stage I |
The cancer is in the prostate only. It is discovered by needle biopsy or in a small amount of tissue during surgery for other reasons like prostatic hyperplasia. The level of PSA is lower than ten and the Gleason score is six or less. Or the cancer could also be found in half or less of one lobe of the prostate. The PSA level is under ten and the Gleason score is six or lower. Or the cancer can’t be felt when a digital rectal exam is given and can’t be seen in the imaging tests. Cancer is in one half or less of a lobe of the prostate. The PSA level and Gleason score are unknown. |
|
|
Stage II |
Stage II A |
During this stage the cancer is found by needle biopsy or in a bit of tissue in surgery for other reasons. The PSA level is under twenty and the Gleason score is seven; or the PSA level is ten at least but fewer than twenty and the Gleason score is six or under. Or the cancer is also found in half or less of one lobe of the prostate. The PSA level is under twenty and the Gleason score is six or under; or the PSA level is under twenty and the Gleason score is seven. Or the cancer can be in more than half of one lobe of the prostate. |
|
Stage II B |
The cancer can be found in opposite sides of the prostate and the PSA can be any level and Gleason score can go from two to ten. Or the cancer can’t be felt in a digital rectal exam and can’t be seen in imaging tests. The PSA level is twenty or more and the Gleason score can be between two or ten; or the PSA can be any level while the Gleason score is eight or above. |
|
|
Stage III |
The cancer has spread past the outer layer of the prostate and might have spread to the seminal vesicles. The PSA can be any level and the Gleason sore can be between two and ten. |
|
|
Stage IV |
This stage has a PSA at any level and the Gleason score is between two and ten. Cancer has spread over the seminal vesicles to nearby organs and tissues, like the seminal vesicle, bladder, rectum or pelvic wall. Or it may have spread to distant body parts like lymph nodes or bones. Prostate cancer spreads to the bones many times. |
|
Treatment for Prostate Cancer by Stages
There are several different options for treating prostate cancer and plenty of influencing factors which affect your options of treatments. The stage of your cancer, however is one of the most important factors when you are choosing your treatment.
|
Stages |
Description of the Treatment |
|
|
Stage I |
In this stage cancers usually grow quite slowly and might never cause any symptoms or health problems. Men with no symptoms who are older and have other serious health problems could limit their total lifespan, so it is recommended to have active surveillance. Radiation therapy or radical prostatectomy could be options for men who want to start treatment. Healthy and younger men might think about active surveillance, radiation therapy or radical prostatectomy. |
|
|
Stage II |
Stage II A |
Compared with stage 1, stage 2 cancers which aren’t treated with radiation or surgery are more likely to spread eventually outside the prostate and create symptoms. Like stage 1 cancers, active surveillance is a good option for men whose cancer isn’t causing any symptoms and who are elderly or having serious health problems. Radiation therapy and radical prostatectomy are appropriate options. |
|
Stage II B |
Treatment options for men who are healthy or younger can include radical prostatectomy. This could be followed by external beam radiation if the cancer has spread outside of the prostate at the time of surgery, or if the PSA level is still detectable a few months after surgery. Any of the radiation options can be combined with several months of hormone therapy if there’s a larger chance of recurrence based upon the PSA level or Gleason score. |
|
|
Stage III |
These cancers haven’t spread to distant organs or lymph nodes and are likely to come back after treatment. Treatment options include external beam radiation plus hormone therapy, external beam radiation plus brachytherapy, maybe a short course of hormone therapy as well, and radical prostatectomy in selected cases. |
|
|
Stage IV |
These cancers have spread to other organs. A few of them are curable using the same treatments as stage III, but most can’t be cured with a standard treatment. Treatments might include hormone therapy, surgery, external beam radiation and hormone therapy, treatments aimed at bone metastases, chemotherapy, and active surveillance and taking part in a clinical trial for newer treatments. |
|