How many stages of prostate cancer are there?
The number staging system for prostate cancer divides prostate cancers into 4 stages, from 1 to 4. The first stage of prostate cancer is the earliest stage and stage 4 means the cancer has spread to another part of the body. Through this system you can locate the cancer and where the cancer have spread around the body. Once at the doctor, you’ll be subjected to the PSA test and the Digital Rectal Examination. Singly or taken together, the results of these two tests will determine your future.
The first test for staging is a simple blood test. The PSA test can help you to figure out whether levels of PSA (Prostate-Specific Antigens – a protein made entirely by the prostate gland – are produced in your blood). According to the second edition of the book “Prostate Cancer Science and Clinical Practice” men younger than age 50 usually have a PSA <2.5 ng/mL while men older than age 65 frequently have values as high as 6.5 ng/mL or greater. Early detection and treatment are common goals for the management of most cancers.
If the examination is above the normal parameters for the man’s age, a further investigation will be needed. For the second test to determine de stage of prostate cancer, your GP may also realize a digital rectal examination (DRE) to determine whether the prostate feels enlarged. Either a doctor or nurse, will introduce a gloved, lubricated finger into the rectum to determine the size of the prostate and feel for lumps and other anomalies.
There are 2 types of staging for prostate cancer:
The Clinical Stage
The clinical stage is based on the results of tests done before surgery, which includes DRE, biopsy, x-rays, CT and/or MRI scans, and bone scans. X-rays, bone scans, CT scans, and MRI scans may not always be needed. A CT or CAT scan refers to a computerised tomography scan, is a simple and routine test that takes up to an hour. Dye is injected into an arm vein and the patient also drinks a fluid that helps contrast images of the pelvic area. The purpose of the CT scan is to provide information of the possible spread of the cancer to the lymph nodes in the pelvic area. It also provides very accurate measurement of the size and precise position of the prostate relative to the surrounding organs. (MRI) uses a powerful magnetic field to
produce pictures of the internal organs, bone and soft body tissue to again determine if the cancer has spread outside of the prostate.
They are recommended based on the PSA level; the size of the cancer, which includes its grade and volume; and the clinical stage of the cancer.
The Pathologic Stage
The pathologic stage is based on information found during surgery, plus the laboratory results, referred to as pathology, of the prostate tissue removed during surgery. The surgery often includes the removal of the entire prostate and some lymph nodes.
Cancer Staging – TNM Score
In this stage, the doctor gives another score which indicates how much cancer has developed. The TNM Score is practiced around the world to stage cancers that produce as tumors and metastasis elsewhere in the body. The letters T, N, and M apply to various areas of the cancer.
How large is the primary tumor? Where is it located? The T score is the rating and size of the primary tumor. You can’t feel T1 tumors through DRE or imaging. Yet, the T2 tumors can be felt by doctors during DRE. What are T2 tumors? Are those tumors that haven’t grown outside the prostate and are based on cancer growth within the left or right lobes of the prostate. The T3 tumors have grown outside the prostate. They have reached the seminal vesicles, the neck of the bladder, or the connective tissue around the prostate. T4 tumors have spread to tissue near the prostate includ- ing the external sphincter, rectum, bladder levator muscles and pelvic wall.
Has the tumor spread to the lymph nodes? If so, where and how many? The N category indicates if the cancer has spread to the nearby lymph nodes. Imaging tests determine these values. N0 means that the cancer has not spread to the lymph nodes. N1 means it has spread into the nearby lymphatic system. NX means it is unknown if the cancer has reached the lymph nodes.
Has the cancer metastasized to other parts of the body? If so, where and how much? The M score indicates that the cancer has spread to distant body sites which include other lymph nodes, the bones or liver.
What you need to know about the 4 stages of prostate cancer
Stage 1 Prostate Cancer
In stage 1, the cancer is confined to the prostate. Stage 1 prostate cancer can’t be detected during a digital rectal exam (DRE) and is usually expected to be slow growing.
Stage 2 Prostate Cancer
In stage 2, the prostate cancer can be detected during a digital rectal exam (DRE). It’s still confined to the prostate, but the cells may be more abnormal and may grow faster.
Stage 3 Prostate Cancer
In stage 3, the cancer has now spread beyond the prostate and may have potentially spread into the nearby seminal vesicles.
Stage 4 Prostate Cancer
In stage 4, the cancer has spread (metastasized) beyond the prostate into other tissues. Stage 4 prostate cancer commonly spreads to lymph nodes, the bones, liver, or lungs.