1. Health

Prostate Cancer Stages

What are Prostate Cancer Stages

By

Updated June 05, 2009

The "stage" of prostate cancer refers to how advanced or spread throughout the body it is.

Two main systems describe prostate cancer stages. The "TNM" system is the most commonly used, but the Jewett system is used by some doctors. Both are detailed below.

What Does Your TNM Stage Mean?

The TNM system for describing prostate cancer uses the letters “T,” “N,” and “M” to signify “Tumor,” “Nodes,” and “Metastasis.”

The following is the breakdown of exactly what each category in this system means.

Primary tumor (T)

  • TX: The primary tumor was not or could not be assessed.


  • T0: There is no evidence of a primary tumor.


  • T1: The tumor could not be found by examination or with the use of imaging (like ultrasound or an MRI scan), but was incidentally found during a biopsy or surgery.

    --T1a: The tumor is found in 5% or less of the tissue that was taken.

    --T1b: The tumor is found in more than 5% of tissue that was taken.

    --T1c: The tumor was found by needle biopsy after an elevated PSA level.



  • T2: The tumor is found only within the prostate itself.

    --T2a: The tumor is found in 50% or less of one lobe.

    --T2b: The tumor is found in more than 50% of one lobe.

    --T2c: The tumor is found in both lobes.



  • T3: The tumor has extended through the capsule that surrounds the prostate.

    --T3a: The tumor has only gone through the capsule without invading the seminal vesicles.

    --T3b: The tumor has invaded the seminal vesicles.



  • T4: The tumor has invaded structures or tissues near the prostate other than the seminal vesicles. These include the bladder neck, the rectum, and the pelvic wall along with other structures.

Nodes (N)

  • NX: The lymph nodes were not or could not be assessed.

  • N0: The nodes do not show evidence of cancer.

  • N1: The nodes show evidence of cancer.

Metastasis (M)

  • MX: The presence of metastases was not or could not be assessed.

  • M0: There is no evidence of distant metastasis.

  • M1: There is evidence of distant metastasis.

    --M1a: Cancer has been found in lymph nodes far from the prostate.

    --M1b: Cancer has been found in the bone.

    --M1c: Cancer has been found in another area of the body.

    What Does Your Jewett Stage Mean?

    The Jewett system uses the letters A through D to signify the primary staging groups. A is the least advanced and D is the most advanced. Within each primary group, there is a further breakdown of the stages.

    The following is the breakdown of exactly what each category in this system means.

    Stage A

    In Stage A, the primary tumor cannot be detected by examination and is only found incidentally during surgery.

    • --Substage A1: The cancer is well-differentiated (meaning the cancer cells are relatively normal in appearance under the microscope) and is only in a small part of the prostate.

    • --Substage A2: The cancer is moderately or poorly differentiated (meaning the cancer cells look quite abnormal in appearance under the microscope) and is found in more than one spot within the prostate.

    Stage B

    In Stage B, the tumor can be found by examination (either physical examination or by the PSA test), but is only found in the prostate itself.

    • --Substage B0: The cancer cannot be palpated (felt) by the physician, but is found because of a high PSA level.

    • --Substage B1: Only a single nodule or bump is found in one lobe of the prostate.

    • --Substage B2: More than one area of cancer is found in one lobe or both lobes of the prostate.

    Stage C

    In Stage C, the tumor is still only found in the area surrounding the prostate, but has extended through the capsule that covers the prostate and could also have entered the seminal vesicles.

    • --Substage C1: The cancer has spread into through the capsule that contains the prostate.

    • --Substage C2: The cancer has spread through the capsule that contains the prostate and has begun to block the flow of urine from the bladder outlet or the ureters (the thin tubes that carry urine from the kidneys to the bladder).

    Stage D

    In Stage D, the cancer has metastasized or spread distantly from the prostate.

    • --Substage D0: The cancer is found only in the prostate by examination and with imaging tests (like ultrasound or MRI), but blood tests continue to show high levels of certain enzymes that mean the cancer has spread.

    • --Substage D1: The cancer has spread only to the lymph nodes near the prostate.

    • --Substage D2: The cancer has spread to distant lymph nodes, to the bones, or to other organs.

    • --Substage D3: The cancer has spread just as in Substage D2, but the cancer has returned following appropriate treatment.

      Source:

      Kumar V, Abbas A, Fausto N. Robbins Pathologic Basis of Disease 7th Edition. 2004.

  1. About.com
  2. Health
  3. Prostate Cancer
  4. Staging and Grading
  5. Cancer Stages - What are Prostate Cancer Stages

©2014 About.com. All rights reserved.

We comply with the HONcode standard
for trustworthy health
information: verify here.