Here at Man Cave Health, we dedicate ourselves to normalizing the conversation around prostate cancer and men’s health. In the interest of continuing toward this objective, we will be discussing the different stages of prostate cancer.
When a doctor provides a diagnosis of prostate cancer, their next objective is to find out if cancer has spread. If it has, then it is important to know how far it has done so. Doctors call this process staging. Stages of prostate cancer elucidate how much cancer is in a given patient’s body. Additionally, it help to determine the seriousness of the cancer and how best to proceed with its treatment.
It isn’t uncommon either, for doctors to use staging when they refer to survival statistics. PSA blood levels and prostate biopsies are one of the most common methods by which to perform tests that might describe the stage of prostate cancer.
How do prostate cancer staging systems work?
In America we have the AJCC TNM staging system, or the American Join Committee on Cancer TNM system. This system for prostate cancer is based on five crucial points of information:
- The extent of the initial and primary tumor.
- If cancer has spread to lymph nodes in the surrounding areas.
- It also identifies if that cancer has spread to other areas of the body. In other words, whether it has metastasized.
- PSA levels during initial diagnosis
- Finally the Grade Group is considered, which is based on the Gleason score. This determines how possible it is that the cancer will grow or spread, and at speed. Usually, a biopsy can reveal this, and at times surgery.
The different stages of prostate cancer
Doctors divide prostate cancer into four primary stages. Some of these have various substages which we have delineated below:
- Stage 1: This usually entails 3 possible circumstances that match cancer to Grade Group 1 or Gleason score 6 or less. The doctor cannot feel the tumor, nor can they see it via a transrectal ultrasound. It would have most likely been found TURP or a needle biopsy performed due to elevated PSA levels in the blood. Another instance is that the doctor did feel or see the tumor but the cancer has not spread to nearby lymph nodes. This would also require that the cancer has not spread anywhere else, that it remains in Grade Group 1 and that PSA levels are under 10. The final eventuality involves doctors removing the prostate during surgery and that the tumor remained here without spreading.
- Stage 2A: This involves the doctor not feeling or seeing the tumor but PSA levels are between 10 and 20. It’s also possible to find oneself in this stage if they can feel the tumor via digital rectal exam, but it’s in one half or less of only one side of the prostate. PSA levels would be in the same bandwidth and require that the cancer has not spread anywhere else in the body.
- Stage 2B: The cancer has yet to spread from the prostate and has not spread to nearby lymph nodes either. However, it has reached Grade Group 2. PSA levels must also be under 20.
- Stage 2C: As with stage 2B the cancer has yet to spread outside the prostate. However, the Grade Group has reached tier 3 or 4 and PSA levels remain under 20.
- Stage 3A: Cancer still has not spread outside the prostate. Yet it is in the bandwidth of Grade Groups 1 to 4 and PSA levels are at 20 or higher.
- Stage 3B: In this stage the cancer has grown and might have spread outside the prostate, possibly even to seminal vesicles. It could have spread to surrounding tissues. The Grade Group is between 1-4 and PSA levels can be at any level.
- Stage 3C: At this stage, the cancer has not spread to nearby tissues or any lymph nodes. However, the Group Grade is 5 and PSA levels could be at any value.
- Stage 4A: The tumor may or may not be growing into tissues near the prostate. The cancer has also spread to nearby lymphnodes but it has yet to spread anywhere else in the body. Grade Groups and PSA levels can be at any value.
- Stage 4B: The cancer may have spread and grown into areas near the prostate and it may have spread to lymph nodes nearby. In this instance it has also spread to other parts of the body, including distant lymph nodes, bones or other organs. Grade Groups and PSA levels can once again be at any value.
As you can see, prostate cancer stages are rather complex. Check our resources section for further information. Where you can also find inspiration from success and survival stories, or we can help you connect with a prostate cancer survivor.
If you have any questions, or just want to talk, call us at our toll-free hotline: 1(833)HEAL-MEN. You are not alone in this journey. We are here to help guide and support you through it, every step of the way.