Stages Of Prostate Cancer
All malignant lesions are usually categorized into stages that predict how aggressive the cancer is, and what will be its prognosis. These stages may be 1, 2, 3, and 4 and are much more complex than this simple classification. For the staging of prostate cancer, standards are set by American Joint Committee on Cancer (AJCC) TNM system.
Stages Of Prostate Cancer
The clinical stages of prostate cancer are described as under:
T1: Tumor at this stage is usually detected by TURP (transurethral resection of prostate) or needle biopsy. These tests are used for examining PSA levels or abnormal growth of prostate. T1 tumor has further 3 subclasses:
- T1a: It is detected by TURP and at this point, the cancer involvement in the removed tissue is 5% or less.
- T1b: It is also detected by TURP but in this case cancer presence in the removed tissue is over 5%.
- T1c: It is detected by biopsy needle.
T2: In size, these tumors are comparatively larger than T1 tumors and are also divided into 3 further subclasses:
- T2a: At this stage cancer spreads to half of the either lobe of the prostate
- T2b: Cancer spreads to more than half of the either lobe of the prostate
- T2c: cancer presence spreads to either sides of the prostate.
T3: At this point, the tumor begins growing outside the prostate.
T4: Tumor metastasizes into the nearby tissues.
N: Symbolizes the metastasis of cancer into the lymph nodes.
M: Symbolizes whether cancer has invaded other body organs by invading blood or lymphatic streams.
The cancer staging also depends on the PSA levels and Gleason score. When prostate exhibits improper functioning due to any reason, the PSA count in the bloodstream goes up. On the other hand, Gleason score suggest how aggressive the cancer is and what would be its outlook.
Stage 1: At stage 1 the prostate cancer is rather slow in growth and is usually not detected easily via examination. Both PSA levels and Gleason score are considerably low at this point.
Stage 2: At this stage, the cancer remains confined within the prostate but become detectable by the doctor. The Gleason score and PSA count is higher as compared to that in stage 1. Based on location and size, stage 2 may be classified as 2a and 2b.
- 2a: It is like tumor at T1 stage with high Gleason score or PSA count or it is like T2a OR t2b with lower levels of PSA or Gleason score.
- 2b: It is comparable to tumor at T2c stage or like tumor at T2a or T2b stage with high Gleason score or PSA count.
Stage 3: At this point, the cancer begins growing right outside the prostate. It may reach the seminal vesicles but not as far as the rectum or bladder
Stage 4: This is a very advanced stage of prostate cancer because to this point the cancer has metastasized into the nearby organs like rectum or bladder or to the nearest lymph nodes. Usually stage 4 cancer is not curable so the treatment regimen aims to provide the symptomatic treatment and to control the already spread cancer growing any further. The treatment options may include:
- Active surveillance
- Hormone therapy
- Catalona, W. J., Richie, J. P., Ahmann, F. R., M’liss, A. H., Scardino, P. T., Flanigan, R. C., … & Waters, W. B. (2016). Comparison of Digital Rectal Examination and Serum Prostate Specific Antigen in the Early Detection of Prostate Cancer: Results of a Multicenter Clinical: Trial of 6,630 Men. The Journal of urology.