Prostate Cancer Staging
The staging process for prostate cancer differs from the way other types of cancer are staged. When prostate cancer spreads, it’s often found in nearby lymph nodes. If cancer has reached these nodes, it also may have spread to other lymph nodes, the bones, or other organs.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if prostate cancer spreads to bones, the cancer cells in the bones are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. For that reason, it’s treated as prostate cancer, not bone cancer. Doctors call the new tumor “distant” or metastatic disease.
Staging considers the tumor size, lymph node involvement, and whether it's spread to other areas of the body.
There are two additional factors used to determine prostate cancer stage:
There are five grades of prostate cancer. Stage 1, which is low grade and slower growing, through Stage 5, which is high grade and rapidly growing. The grade is related to the Gleason Score determined during the biopsy.
Grade 1: Gleason score of 6 or less
Grade 2: Gleason score of 3+4=7
Grade 3: Gleason score of 4+3=7
Grade 4: Gleason score of 8
Grade 5: Gleason score of 9 or 10
In stages 1 through 3, the oncologist will consider whether the PSA test result was above 10 but below 20 (medium) or above 20 (high). At Stage 4 prostate cancer, the PSA level doesn't have as much of an impact on the treatment path that will be recommended because it has moved outside of the prostate.
Understanding the Prostate Cancer Pathology Report
These are the stages of prostate cancer:
Stage I Prostate Cancer
The cancer can’t be felt during a digital rectal exam, and it can’t be seen on a sonogram. It’s found by chance when surgery is done for another reason, usually for BPH. The cancer is only in the prostate. The grade is G1, or the Gleason score is no higher than 4.
Stage II Prostate Cancer
The tumor is more advanced or a higher grade than Stage I, but the tumor doesn’t extend beyond the prostate. It may be felt during a digital rectal exam, or it may be seen on a sonogram.
Stage III Prostate Cancer
The tumor extends beyond the prostate. The tumor may have invaded the seminal vesicles, but cancer cells haven’t spread to the lymph nodes.
Stage IV Prostate Cancer
The tumor may have invaded the bladder, rectum, or nearby structures (beyond the seminal vesicles). It may have spread to the lymph nodes, bones, or to other parts of the body.
Prostate Cancer Doctors at Cancer Care Centers of Brevard
If you or a loved one has received a new prostate cancer diagnosis, our prostate cancer specialists and radiation oncologists are here to guide you through this journey. Our cancer doctors work with each patient to create an individualized treatment plan based on your specific prostate cancer diagnosis. We offer patients a comprehensive and compassionate approach to cancer care and have access to advanced prostate cancer treatment options at our cancer centers throughout Brevard County, including Melbourne, Palm Bay, Merritt Island, and Rockledge, FL.