Stages Of Prostate Cancer
The prognosis and outcome of cancers depends largely on the aggressiveness of tumor and extent of tissue involvement. The American Joint Committee on Cancer (AJCC) has devised a system to identify the aggressiveness of various cancers. This classification system is universal and helps in informing healthcare providers across the globe regarding the clinical status of an individual suffering from a certain malignant condition, their prognosis and possible treatment options.
What are different stages of prostate cancer?
This classification system categorizes the cancers into one of the 4 stages; these are:
The TNM classification is discussed as under:
T1: The detection of prostate malignancy at this stage is usually performed by micro-invasive diagnostic tools such as needle biopsy or transurethral resection of prostate to further investigate positive findings on PSA analysis or abnormal growth on the prostate gland on palpation.
There are 3 further classes of this Prostate Cancer stage:
- T1a: This stage involves penetration of cancerous cells in up to 5% of the removed cancerous mass during TURP
- T1b: Penetration of cancerous cells in more than 5% of the removed tissue during TURP qualifies for T1b stage
- T1c: This stage is identified by presence of cancerous cells during needle biopsy
T2: In this stage, the tumor mass is larger in size compared to T1 cancerous masses and can be further classified as:
- T2a: Spread of cancerous cells to less than 50% of either half of prostate gland/ lobe
- T2b: Spread of cancerous cells to more than 50% of either half of prostate gland/ lobe
- T2c: Presence of cancerous cells on either side of the prostate gland/ lobe
T3: Spread of tumor cells outside of prostate gland
T4: Spread of prostate tumor cells to surrounding tissues
N – This stage refers to spread of tumor cells to the surrounding lymph nodes
M – This stage refers to spread of tumor cells to surrounding tissues as tumor cells invade blood and lymphatic vessels
What else to look for while defining the prognosis of Prostate cancer?
Healthcare providers also analyze the Gleason score and PSA levels (prostatic specific antigen) for cancer prognosis. Malfunctioning of prostate gland (such as due to cancer) often presents with high prostatic specific antigen. Likewise, Gleason score is a measure of the aggressiveness of the cancer.
- Stage 1: This is early stage cancer where both Gleason score and PSA level are generally normal or near normal.
- Stage 2: In this stage, the tumor mass is detectable or palpable. The PSA levels and Gleason score begin to rise in this stage. It is divided into two stages
- The stage is defined by high PSA levels and Gleason score with histological features of T1 tumor OR low PSA levels and Gleason score with histological features of T2a or T2b
- This stage is characterized by high PSA levels and Gleason score with histological features of T2a or T2b or histological features of T2c
- Stage 3: Migration of cancerous cells outside of prostate – up to the levels of seminal vesicles but not reaching up to bladder or rectum
- Stage 4: Advanced stage of cancer that is marked by distant spread to nearby tissues – up to rectum and bladder. The prognosis is generally poor at this stage.
Speak to your doctor if you are experiencing symptoms of prostate enlargement or growth to detect the issue at an early stage for better prognosis and treatment outcome.