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Does Prostate Cancer Have Stages

Screening For Prostate Cancer

Living with advanced prostate cancer

There are no tests available with sufficient accuracy to screen populations of men for early signs of prostate cancer. However, early detection and treatment can significantly improve prostate cancer survival.

The test most commonly used to aid early detection of prostate cancer is the prostate specific antigen blood test. This is not a diagnostic test as it can only indicate changes in the prostate. If you are concerned about prostate cancer you should talk to your doctor and make an informed choice about whether to have one of the tests designed to find early signs of prostate cancer, in view of the potential risks and benefits.

There are no proven measures to prevent prostate cancer.

The Staging Guide Video Series

Hi, Im Dr. Scholz. Lets talk about prostate cancer.

Weve been going through a series of short videos about the management of Teal otherwise known as intermediate risk prostate cancer. In this video were going to cover the comparison of all the different treatment options for Teal, and try to give you a little hierarchygive you a kind of number 1, 2, 3 in terms of options that I would be thinking of if I was in this situation.

First, when youre talking about Teal you have to realize there are three subtypes, the Teal subtype we divide at PCRI into Low, Basic, and High. So when we talk about many options for treating teal, were really talking about Basic-Teal. Why is that? Well, Low-Teal those men are candidates for active surveillance. High-Teal are going to get better cure rates with combination therapythat is a seed implant plus IMRT and a short course of hormone blockade . For Basic-Teal were really talking about having a broad selection of therapy amongst surgery, radiation therapy which could be IMRT, proton therapy, SBRT stereotactic body radiation CyberKnife, two different types of seed implants, and even primary hormone blockade , or just TIP alone which was very popular before radiation technology got a lot better. So the remainder of the video is really going to be talking about options or Basic-Teal, comparing the pros and cons of all these different treatments.

So lets move on and talk about that, lets talk about discomfort and inconvenience.

Side Effects Of Hormone Therapy

Hormone therapy may cause side effects associated with low testosterone, such as hot flashes, sweating, weight gain, reduced sexual desire and depression. Some men also may experience swollen breasts, depression, memory loss and heart problems. Eventually, the cancer may become resistant to hormone therapy. If hormone therapy stops working, doctors may switch treatments.

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Stage : Prostate Cancer Involves More Of The Prostate And A Lump Is Detectable In An Exam

This category is divided into two stages: stage 2A and stage 2B.

In stage 2A, features are like stage 1, with these changes:

  • PSA is at least 10, but less than 20.
  • Gleason score is 6 but can be lower if diagnosis was by needle biopsy for conditions other than cancer.
  • Cancer can be found in one half or less of the prostate lobe or more than one lobe.

Stage 2B cancer means that:

  • The prostate cancer is more extensive, extending to opposite sides of the prostate. It might be detectable with a digital rectal exam. In this instance, the PSA lower than 20 and the Gleason score is 7, according to the National Cancer Institute.
  • Alternatively, cancer remains undetectable in the digital rectal exam and imaging tests. PSA is lower than 20 and the Gleason score is 7.
  • Yet another way this can manifest is with a Gleason score of 8 or more, PSA at any level, but imaging and DRE do not pinpoint the cancer.

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After prostate cancer surgery, most men will get back to normal within six to eight weeks, but you may be able to go back to work within 3-4 weeks. After any type of therapy, you should be able to return to work the next day or if there are no symptoms that interfere with your ability to work. Make sure to ask your doctor how long until you can resume your normal activities, including exercises and heavy lifting.

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Pathological Stage: A Look At The Actual Cancer Cells And Their Distribution Within The Pelvic Area

This system assesses how pervasive the cancer cells are within and around the prostate. These stages begin at T2.

T2: The tumor is located in the prostate only.T3: The tumor has breached the prostate border on 1 or more sides.T3b: The tumor has begun to grow in the seminal vesicles.T4: The tumor has grown into other neighboring structures, like the bladder, the rectum, or the pelvic wall.

Treatments May Have Side Effects

The treatment options for early-stage prostate cancer fall into three broad categories: surgery, radiation therapy, and active surveillance. Your doctor will make a treatment recommendation based on your numbers as well as a mathematical tool known as a nomogram, which can help you and your doctor better assess how extensive your cancer is likely to be and whether it is likely to become active in the future.

Yet clinical studies have not provided any evidence that one treatment is better than another or that any treatment at all actually prolongs life: The average 5-, 10-, and 15-year survival rates are virtually the same for all treatment options in early-stage prostate cancer, including active surveillance. Its also important to understand that no mathematical model is foolproof, and some men diagnosed with early-stage, locally confined disease will later find out that their cancer was more extensive than originally believed.

If you are diagnosed with early-stage prostate cancer, you have a number of treatments to choose from. A brief comparison is listed in Table 2.

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Fast Facts On Prostate Cancer

  • Prostate cancer rarely reaches an advanced stage.
  • People with the condition normally have a very good outlook when they receive an early diagnosis and treatment.
  • Hormone therapy is a treatment option for advanced prostate cancer, as are chemotherapy and immunotherapy.
  • Prostate cancer can spread to the bones, brain, and lungs.

Prostate cancer occurs when cells in the prostate gland mutate and start to develop abnormally, multiplying at an uncontrolled rate. In some instances, the cancerous cells can spread to other body parts through tissue, the blood, or the lymphatic system.

After a doctor diagnoses prostate cancer, they will test to see if the cancer has spread to other areas of the body, or how much of the body is affected.

The doctor will assign a stage of prostate cancer from 1 to 4. Stage 4 is the most advanced form.

Stage 4 prostate cancer has spread to pelvic lymph nodes or is blocking the ureters. The ureters are the tubes that connect the kidneys to the bladder. Stage 4 prostate cancer may also have spread to the bladder, the rectum, the bones, or distant lymph nodes.

Doctors will test any cancerous cells in the body to determine if the additional cells came from the prostate. Even if they detect cancer in the bones, doctors still consider this prostate cancer if that is where the cancer originated.

There are two types of stage 4 prostate cancer:

What Are The Stages Of Prostate Cancer

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If you are diagnosed with prostate cancer, the first thing your doctors will do is assess if and how much the cancer has spread. This process is called staging.

Prostate cancer, like all cancers, will fall into one of four stages. In stage 1, the cancer has not spread. The succeeding stages define gradually advanced stages of cancer up to stage 4, which describes cancer that has spread to other areas of the body.

Staging cancer is an important part of diagnosis and treatment. It helps doctors determine your treatment plan, and it helps patients understand how they will move forward.

Learning more about staging will help you understand what to expect from these early days of your diagnosis and make decisions regarding treatment.


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What Is The Outlook

No cure is available for stage 4 prostate cancer. Your healthcare team will work with you to help control the cancer for as long as possible while maintaining a good quality of life.

Your outlook will depend on how fast the cancer is spreading and how well you respond to therapies.

With treatment, you can live for many years with metastatic prostate cancer.

How Prostate Cancer Is Diagnosed And Staged

Cancer staging helps you and your doctor understand how advanced your cancer is and how much it has spread at the time of diagnosis. Knowing your cancer stage also helps your doctor determine the best treatment options for you and estimate your chance of survival.

The most widely used staging system for cancer is the TNM system that classifies cancer from stage 1 to stage 4.

TNM stands for:

  • Tumor: the size and extent of the tumor
  • Nodes: the number or extent of nearby lymph node involvement
  • Metastasis: whether cancer has spread to distant sites in the body

The TNM scale is used for many types of cancer. When a doctor uses it to determine your prostate cancer stage, theyll consider several other factors as well, including:

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Metastatic Prostate Cancer Treatment

If a patient has been diagnosed with prostate cancer and he or she is concerned about prostate cancer metastasis, they should talk with a doctor about the risk of prostate cancer metastasis and corresponding treatment options.

Treatments for stage 4 prostate cancer may depend on where in the body the disease has spread. Options include:

More Detail On Prostate Cancer Staging

Prostate Cancer: Causes, Symptoms And Treatment

The standard Tumor, Node, and Metastasis system is used to stage prostate cancer. The T category is based on the extent of the tumor itself. The N category is based on whether the cancer has spread to nearby lymph nodes. The M category is based on whether the cancer has spread beyond nearby lymph nodes to distant organs.

T Categories:

  • T1: the tumor cannot be felt with a DRE or seen with imaging
  • T1a: the tumor is found accidentally during a surgery for benign prostatic hyperplasia or another prostate condition. The tumor takes up less than 5% of the removed tissue
  • T1b: the tumor is found accidentally during a surgery, and the tumor takes up more than 5% of the removed tissue
  • T1c: the tumor is diagnosed with a needle biopsy, usually because of an elevated PSA
  • T2: the tumor is confined to the prostate and can be either felt with a DRE or seen with imaging
  • T2a: the tumor is confined to half of one lobe of the prostate
  • T2b: the tumor is present to more than half of one lobe, but is not in both lobes
  • T2c: the tumor is present in both lobes of the prostate
  • T3: the tumor has grown outside of the prostate and may be present in the seminal vesicles
  • T3a: the tumor is outside of the prostate, but is not in the seminal vesicles
  • T3b: the cancer is outside of the prostate and has spread to the seminal vesicles
  • T4: the tumor has grown into tissues beyond the seminal vesicles
  • N Categories:

    M Categories:

    Each of the stages is based on some combination of these categories.

    Stage I:

    Stage IIA:

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    Can Adt Compensate For Dose Escalation

    The Prostate Cancer Study III examined the addition of ADT to SDRT and DERT in intermediate-risk patients . The preliminary results of this trial have now been published in abstract form. A total of 600 patients were enrolled. Intermediate-risk prostate cancer was defined as T1/T2 disease, GS 6, PSA level 1020 ng/mL or T1/T2 disease, GS of 7, PSA level 20 ng/mL. Patients were randomly assigned to one of three arms: 6 months of ADT plus 70 Gy to the prostate , 6 months of ADT plus 76 Gy , or 76 Gy alone . ADT consisted of bicalutamide and goserelin for 6 months. RT was delivered using a 3D conformal technique and started 4 months after the beginning of ADT. Median follow-up was 6.75 years. Primary endpoints were biochemical failure and disease-free survival . Secondary endpoints included OS, as well as hormonal and radiation-related toxicities. Biochemical failure was defined as 2 ng/mL above the PSA nadir.

    When To See A Doctor

    If a person experiences any of the symptoms of prostate cancer, such as changes in the flow or frequency of urination, it is important to talk with a doctor.

    While these symptoms could also occur due to other conditions, such as BPH or prostatitis, a doctor can help determine the cause and best course of treatment.

    Even without obvious symptoms, a person may also want to discuss

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    The Tnm System For Prostate Cancer Stages

    As they do for most cancers, doctors use the TNM system to describe prostate cancer stages. The system uses three different aspects of tumor growth and spread:

    • Tumor. Whatâs the size of the main area of prostate cancer?
    • Nodes. Has it spread to any lymph nodes? If so, how far and how many?
    • Metastasis. How far has the prostate cancer spread?

    Life Expectancy And Localized Prostate Cancer

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    So how do these treatments affect life expectancy? In one study, researchers in Switzerland examined the treatment and outcomes of 844 men diagnosed with localized prostate cancer. They compared men who had been treated with prostatectomy, radiotherapy and watchful waiting and found that at five years from diagnosis, the type of treatment made little difference to survival. When the researchers went to 10 years from diagnosis, they did find a difference in survival based on treatment, but it was fairly small.

    After 10 years, 83 percent of the men who had gotten a prostatectomy were still living, compared to 75 percent who had undergone radiotherapy and 72 percent who took a watchful waiting approach.

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    Understanding Prostate Cancer Stages

    • Prostate Cancer, Stage I

      In stage I prostate cancer, the cancer is limited to one side of the prostate, and it has not spread to lymph nodes or other areas of the body. Both the PSA levels and Gleason score are low. At this stage, the cancer tends to grow very slowly and is therefore largely curable. The survival rate for stage I prostate cancer is nearly 100%.

    • Prostate Cancer, Stage II

      While the cancer may be present across the prostate gland, it has not spread to lymph nodes or other areas of the body. The PSA levels and Gleason score will likely be higher than average, but the survival rate for this stage of prostate cancer is still nearly 100%.

    • Prostate Cancer, Stage III

      In stage III, the cancer has spread to other tissues or is on the brink of spreading to lymph nodes or other areas of the body. If the cancer has spread to other areas, it is localized near the prostate and has not affected lymph nodes. The survival rate is still almost 100%.

    • Prostate Cancer, Stage IV

      This is the most advanced stage of prostate cancer. In this stage, the cancer has spread to areas beyond the prostate and nearby tissue, like the lymph nodes, bones, or other organs. When diagnosed with stage IV prostate cancer, the five-year survival rate is about 30%.

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    What Is The Treatment For The Final Stages Of Prostate Cancer

    End stage prostate cancer means a person cannot be cured, and they will die from cancer. Palliative care, also called supportive care or comfort care, is used to help manage or relieve symptoms of end-stage prostate cancer.

    The goal of palliative care is to improve a patients quality of life and relieve suffering. Palliative care can help patients cope with physical symptoms such as pain, fatigue, shortness of breath, loss of appetite, nausea, constipation, and difficulty sleeping , and mental/emotional symptoms such as depression and anxiety.

    Hospice care may also be an option for terminally ill patients with a limited life expectancy and may begin if a patients condition is unable to be cured or managed. The only goal of hospice care is comfort and quality of life. Palliative care may occur in a hospice, in a patients home, in the hospital, or a long-term care facility.

    Palliative care may include treatment to alleviate symptoms and keep a patient comfortable, such as:

    • Help with medications

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    Prostate Cancer Survival Rate By Stage

    The latest data about survival based on stage at diagnosis is from 20111. It shows high survival outcomes for localised and locally advanced prostate cancers , with at least 98% of people surviving 5 years from diagnosis. For Stage 4 prostate cancer, it showed 36.4% of people survived 5 years from diagnosis.

    Its important to remember that survival rate is based on past statistics and cannot predict your individual situation.

    1. Relative survival by stage at diagnosis , Cancer Australia,

    Methods of staging prostate cancer include PSMA PET/CT scan, CT scan and whole-body bone scan.

    How Many Stages Does Prostate Cancer Have

    CIENCIASMEDICASNEWS: Alternate Driver of Treatment

    In the UK, about 1 in 8 men will get prostate cancer in their lifetime.

    Prostate cancer mainly affects men over 50, and your risk increases with age. The risk is even higher for black men and men with a family history of prostate cancer.

    Find out more about your risk.

    See and share our infographic on prostate cancer risk.

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