Staging prostate cancer involves recording the size, aggressiveness and growth of a tumor. Knowing these key details helps doctors personalize treatments and determine your prostate cancer prognosis (the predicted outcome).
Prostate cancer has a lot of different treatment options. Knowing the prostate cancer stage helps your doctors narrow down your options. It also helps you make informed care decisions based on the characteristics of the cancer, your quality of life, emotional health and treatment goals.
Why Prostate Cancer Staging Is Important
Staging systems give doctors a common language to classify tumors. Staging helps you and your doctors understand:
- The tumor’s size
- The tumor’s location
- Whether the cancer has spread (metastasized) to nearby lymph nodes, tissues and other parts of the body
Staging prostate cancer also helps our experts compare your situation to other people with prostate cancer. They use the knowledge gained from treating patients with similar cancers in your care.
They can also review clinical studies on groups of patients in similar cancer stages. This process helps them determine the prostate cancer prognosis and how different treatments may work.
What Are the Four Stages of Prostate Cancer?
The stages of prostate cancer are:
- Stage I: Cancerous cells are only in the prostate. Doctors may also classify the stage as IA, IB or IC, depending on how deeply the cancer has invaded the prostate lining.
- Stage II: Cancer is only in the prostate and has not spread. Doctors may also classify Stage II cancers as Stage IIA or IIB, depending on whether the cancer has invaded the supportive tissue around the prostate.
- Stage III: The cancer has spread outside the prostate and may be in the seminal vesicles (reproductive glands that produce the fluid in semen). In Stage IIIA, cancer has not spread to the seminal vesicles. In Stage IIIB, it has spread.
- Stage IV: The cancer has spread beyond the prostate into tissues beyond the seminal vesicles, such as the:
- Urethral sphincter (the on-off switch of the tubelike organ that drains urine from the bladder)
- Rectum
- Wall of the pelvis
Gleason Score and Prostate Cancer Grading
Prostate staging is complicated and involves many factors. One of these factors is a Gleason score or grade. The Gleason score is a number between 6 and 10 that describes how cancer cells look under a microscope.
The lower the prostate cancer grade, the more normal cancer cells appear. Most prostate cancers are grade 6 or higher. When abnormal cells are in different areas of the cancer, doctors assign the two largest areas their own grades. These numbers are added to create a Gleason score (or sum).
The highest your Gleason score can be is 10. The higher the Gleason score, the more aggressive the prostate cancer is.
How We Stage Prostate Cancer
If you are diagnosed with prostate cancer, a series of tests help determine the cancer’s stage. Those tests include the prostate-specific antigen (PSA) blood test and a prostate biopsy.
Doctors called pathologists analyze tumor tissue removed during biopsies. Pathologists at the Abramson Cancer Center have the highest level of training in urologic cancers like prostate cancer. Their expertise helps them provide critical details that others may miss. This information helps us better tailor treatments to your situation.
Less Invasive Biopsies at the Abramson Cancer Center
We offer a less invasive biopsy called analysis of circulating tumor DNA, or liquid biopsy. Liquid biopsies are simple blood tests that analyze cancer DNA.
Liquid biopsies help us pick the treatments proven to stop a specific cancer’s growth. These treatments are called targeted therapies.
Read more about diagnosing prostate cancer at the Abramson Cancer Center.
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