Once a doctor finds a cancer in the prostate, it’s important for him to find out how far it has spread. That’s known as staging. Knowing the stage of your cancer helps doctors plan treatment that has a good chance of controlling or eliminating it.
To find out the stage of your cancer, your doctor will take a biopsy sample from your prostate gland and have it examined by a pathologist. This specialist will give the tissue a Gleason score, which is set by adding together the two most common patterns of cancer cells found in the sample.
When doctors know your Gleason score, they can determine how likely it is that the cancer has spread beyond the prostate. This information is used to classify your cancer into one of four stages. The stages describe how advanced the cancer is, how big it is and whether it has spread to other tissues or organs in the body.
Your doctor will also look at your PSA levels for screening and staging purposes. The higher your PSA level, the more likely it is that you have prostate cancer. PSA levels drop once the cancer has been treated and are less likely to return.
The T stage of your cancer reflects how large the original tumor is and where it is located. It also indicates if the cancer has reached nearby lymph nodes or other parts of the body. The T stage of your cancer can be further divided into substages based on how aggressive the cancer is or how likely it is to spread.
Stage 1: The cancer is limited to the prostate and has not spread. This is often the case when a cancer is discovered as part of a needle biopsy for benign prostatic hyperplasia (BPH), which causes an enlarged prostate, or because of abnormal PSA blood tests.
T3: The cancer has grown into surrounding structures, like the bladder opening and seminal vesicles or muscles in the pelvic area. This is the most common stage of progression.
Stage 4: The cancer has spread to other tissues or organs in and around the body. It can also be classified into two substages:
Pathological TNM staging parallels clinical TNM staging, with the exception of pathological T1 and pT2 tumors. If you are a patient with histopathologically confirmed organ-confined prostate cancer after radical prostatectomy (RP), your stage will be pT1c.
