Staging
Staging is a process that tells a doctor if the cancer has spread and if it has, how far. Staging of prostate cancer depends on whether the tumor has invaded the lymph nodes, nearby tissue, or other parts of the body. Staging of prostate cancer also depends on your Gleason score and PSA level. The Gleason score is a way for doctors to grade the aggressiveness of your cancer. Staging is an important step in evaluating prognosis and treatment options.
Stage I
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Description
- Cancer found only in the prostate, but the tumor is too small to be detected by imaging tests or digital rectal exams.
- The PSA level is lower than 10 and the Grade Group is 1.
Please see Risk Assessment and Gleason Grading System for more information.
Treatment
- Active surveillance, radiation therapy, radical prostatectomy.
Stage II
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Description
- Tumor is larger than in stage I, cancer is found in one or both sides and is still confined to the prostate.
- IIa : PSA level is at least 10 but lower than 20 and the Grade Group is 1
- IIb : PSA level is lower than 20 and the Grade Group is 2.
- IIc : PSA level is lower than 20 and the Grade Group is 3 or 4.
Please see Risk Assessment and Gleason Grading System for more information.
Treatment
- Active surveillance, radiation therapy, radical prostatectomy.
Stage III
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Description
- Cancer has grown through the outer layer and spread outside the prostate. It may have spread to the seminal vesicles, but has not invaded any lymph nodes.
- IIIa : PSA level is at least 20 and the Grade Group is 1, 2, 3, or 4.
- IIIb : PSA can be any level and the Grade Group is 1, 2, 3 or 4.
- IIIc : PSA can be any level and the Grade Group is 5.
Please see Risk Assessment and Gleason Grading System for more information.
Treatment
- Radiation therapy, hormone therapy, radical prostatectomy.
Stage IV
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Description
- Cancer has spread past the seminal vesicles and invaded nearby structures such as the bladder or rectum. It may have also spread to the lymph nodes or other parts of the body, most often the bones.
- IVa : PSA can be any level and the Grade Group is 1, 2, 3, 4 or 5.
- IVb : cancer has spread to other parts of the body including bones and distant lymph nodes.
Please see Risk Assessment and Gleason Grading System for more information.
Treatment
- Hormone therapy, chemotherapy, radiopharmaceutics (radium-223, 177Lu-PSMA-617), immunotherapy (sipuleucel-T), clinical trials, palliative clinical trials, palliative treatments.
