After you have been diagnosed with prostate cancer, your physician will determine the stage of your cancer to help guide your treatment plan. To do this, your physician will look at the extent of the primary tumor, any spread to nearby lymph nodes, whether the cancer has spread to other parts of the body, and your level of prostate-specific antigens (PSA). Prostate cancer is also given a grade, called a Gleason score, which describes how likely your cancer is to grow and spread. This information is combined to determine the stage of your cancer. Prostate cancer staging is quite complex. Don’t hesitate to discuss with your provider more to fully understand the state of your disease.
Stage I
Prostate cancer in this stage grows slowly and cannot be felt. The tumor is half the size of one side of the prostate or smaller, and the cancer cells are well-differentiated, which means they look like healthy cells. Men with cancer in this stage have low PSA levels and have a Gleason score of 6 or less.
Stage II
The tumor is small and found only in the prostate but may have an increased risk of growth. PSA levels are medium.
- Stage IIA tumors are similar in size to stage I tumors or are larger with well-differentiated cancer cells. PSA levels are medium, and the Gleason score is 6 or less.
- Stage IIB tumors are found only in the prostate and may be large enough to feel. PSA levels are medium, and the cells are moderately differentiated with a Gleason score of 7.
- Stage IIC tumors are found only in the prostate and may be large enough to feel. PSA levels are medium, and the cells are either moderately or poorly differentiated with a Gleason score of 7 or 8.
Stage III
Prostate cancer in this stage is characterized by high PSA levels, a growing tumor, or a high grade. These cancers are more likely to grow and spread.
- Stage IIIA cancers have spread from the prostate into nearby tissues. PSA levels are high with a Gleason score of 8 or less.
- Stage IIIB cancers have spread from the prostate into nearby structures like the bladder or rectum and have a Gleason score of 8 or less.
- Stage IIIC cancer cells are poorly differentiated with a Gleason score of 9 or 10.
Stage IV
Prostate cancer in this stage has spread outside of the prostate. Cancers in this stage can have any grade or level of PSA.
- Stage IVA cancers have spread to lymph nodes in the same region as the prostate.
- Stage IVB cancers have spread to distant lymph nodes, other parts of the body, or to the bones