The stage of a cancer tells you about how big it is and how far it has spread. 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.
More commonly doctors use the TNM system to stage prostate cancer.
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 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
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
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
Stage 4 can mean different things, including:
- The cancer has spread into nearby body organs, such as the back passage or bladder.
- The cancer has spread to nearby lymph nodes.
- 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
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
- symptom control treatment
- high frequency ultrasound therapy (HIFU) as part of a clinical trial
- cryotherapy as part of a clinical trial