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Number staging system

Find out about the number staging system for prostate cancer and treatment.

Your scans will give some information about the stage of your cancer. But your doctor might not be able to tell you the exact stage until you have surgery.

Doctors sometimes use the number system to stage prostate cancer. This system divides prostate cancer into 4 stages.

TNM stages

The TNM staging system stands for Tumour, Node, Metastasis.

  • T describes the size of the tumour
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

Or your doctor may describe your cancer as localised, locally advanced or advanced.

Stage 1

Stage 1 means the cancer is in only half of one side of the prostate, or less. It is completely contained within the prostate gland.

In the TNM staging system stage 1 prostate cancer is the same as one of the following:

  • T1, N0, M0
  • T2a, N0, M0
Diagram showing stage 1 prostate cancer

Stage 2

Stage 2 means the cancer is in more than half of one side of the prostate. But it is still completely contained within the prostate gland.

In the TNM staging system stage 2 prostate cancer is the same as one of the following:

  • T2b, N0, M0
  • T2c. N0, M0
Diagram showing stage 2 prostate cancer.jpg

Stage 3

Stage 3 means the cancer has broken through the capsule (covering) of the prostate gland. It may have spread into tubes that carry semen (seminal vesicles).

In the TNM staging system stage 3 prostate cancer is the same as this:

  • T3, N0, M0
Diagram showing stage 3 prostate cancer

Stage 4

Stage 4 can mean different things, including:

  • The cancer has spread into nearby body organs, such as the back passage or bladder.
Diagram showing stage 4 prostate cancer
  • The cancer has spread to nearby lymph nodes.
Diagram showing metastasis of prostate cancer
  • The cancer has spread to other parts of the body outside the pelvis, such as the lungs or liver.

In the TNM staging system stage 4 prostate cancer is the same as:

  • T4, N0, M0
  • Any T, N1, M0
  • Any T, any N, M1

Treatment

The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:
  • what the cancer cells look like under the microscope (Gleason score)
  • your PSA blood test level
  • your type of cancer (the type of cells the cancer started in)
  • your age and general health
  • how you feel about what the treatments involve and the side effects

You might not have treatment straight away. Sometimes your doctor monitors your cancer and starts treatment if the cancer begins to grow. Depending on your situation, they may call this:

  • active surveillance
  • watchful waiting
If you have treatment this might include:
  • surgery to remove your prostate
  • external radiotherapy
  • internal radiotherapy (brachytherapy)
  • hormone therapy
  • high frequency ultrasound therapy (HIFU) as part of a clinical trial
  • cryotherapy as part of a clinical trial
  • chemotherapy
  • symptom control treatment
Last reviewed: 
06 Jul 2016
  • AJCC Cancer Staging Manual (7th Edition)
    S Edge and others. Springer, 2011

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2014

  • Cancer of the prostate: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    C  Parker and others
    Annals of Oncology, 2015. Vol 26 (suppl 5): v69-v77

  • Prostate cancer: diagnosis and management

    National Institute of Health and Care Excellence (NICE) guidelines, January 2014.

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