Prostate cancer staging
Before your loved one’s doctor assigns a “stage” for his prostate cancer, he may order a number of additional tests to help determine if the cancer appears to be confined to the prostate (called localized prostate cancer), or has spread outside the prostate (called advanced prostate cancer). These tests may include a bone scan, a CT or CAT scan, MRI, or a ProstaScint™ scan. Prostate cancer staging is based on the results of all of your loved one’s tests, physical exams, and biopsy. The TNM staging system is the most commonly used system for determining prostate cancer stages. With the TNM system, the T stands for the local extent of the tumor. N represents the presence of metastases (the spread of cancer) to nearby lymph nodes. The M represents the presence of “distant” metastases to other parts of the body (the cancer travels in the bloodstream to bony areas, usually the pelvis, ribs, or long bones). Below is a prostate cancer staging table that lists all the categories.
T categories | | T0: There is no evidence of a tumor. | | | T1: The tumor cannot be felt (is not palpable) during a digital rectal exam or be seen with imaging tests. | | | T1a: Tumor was discovered unintentionally (called incidentally) in tissue removed for other reasons and 5% or less of the tissue removed is cancerous. | | | T1b: Tumor was discovered incidentally and more than 5% of the tissue removed is cancerous. | | | T1c: Tumor was found by a needle biopsy that was performed because of a high PSA. | | | T2: Tumor appears to be only inside the prostate gland. | | | T2a: There is cancer in one half (or less) of just one side of the prostate (called one lobe). | | | T2b: There is cancer in more than half of only one side of the prostate. | | | T2c: There is cancer in both sides of the prostate. | | | T3: Cancer extends outside of the prostate. | | | T3a: Cancer has grown beyond the wall of the prostate (called extracapsular extension) on one or both sides. | | | T3b: Cancer has invaded the seminal vesicles. | | | T4: Cancer has invaded other areas (other than the seminal vesicles) near the prostate, such as the bladder or rectum. | |
N categories | | N0: Cancer has not spread to nearby lymph nodes (called regional lymph nodes). | | | N1: Cancer has spread (called metastasis) to regional lymph nodes. | |
M categories | | M0: Cancer has not spread to other areas beyond the regional lymph nodes. | | | M1: Cancer has spread to areas beyond the regional lymph nodes (called distant metastasis). | | | M1a: Cancer has spread beyond the regional lymph nodes to other lymph nodes. | | | M1b: Cancer has spread to the bones. | | | M1c: Cancer has spread to other areas in the body, such as the lungs, the liver, or the brain (and may or may not be in the bones). | |
Always discuss everything you read on this web site with a qualified medical professional.
Updated 10/09
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References:American Urological Association. The Management of Localized Prostate Cancer. http://www.auanet.org. Accessed September 1, 2008. Walsh PC. Guide to Surviving Prostate Cancer. New York, NY: Time Warner Book Group; 2001.
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