The staging of prostate cancer is the process by which the cancer’s extent or spread is measured. There is a uniform system for classifying prostate cancer based on its stage.
The most commonly used staging system today is the TNM system. However, some hospitals and physicians use another staging system known as the Jewett staging system. If your doctor has given you a stage for your prostate cancer in this system, it is important to understand what it means.
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.
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.
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.
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).
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.