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Clinical stages of Prostate Cancer

Stage T1

Tumour Confined to the Prostate, Low Risk of Metastases

In Stage T1, the tumour is confined to the prostate gland only and cannot be felt during a rectal exam. The tumour is likely to cause no symptoms. It is often found by chance during treatment for BPH, prostatitis, or some other prostatic problem.

If in Stage T1, the patient’s blood Ievels of PSA are higher than normal, and cancer cells are found after needle biopsy of the prostate. Cancer cells may be found in only one area, or in many areas, of the prostate.

Common Treatment Choices

The doctor may recommend radical surgery or radiation therapy. For some men, no treatment may be a sensible option. This is especially true for those men at Stage T1, or for those whose life expectancy is short due to other diseases. Instead of surgery or radiation therapy, the size and activity of the cancer is watched by your doctor during regular rectal exams and PSA tests. Treatment may be started when, and if, needed. See Watchful Waiting.

T2bT1a

The tumour is not palpable (cannot be felt by the doctor) and is very small (less than 5% of the tissue removed on biopsy).

T2bT1b

Although small and not palpable, the tumour is in more than 5% of the tissue removed on biopsy.

T2bT1c

The tumour is small and not palpable but is found only by using needle biopsy. The blood level of PSA is high.


Stage T2

Tumour Confined to the Prostate, Medium Risk of Metastases

In Stage T2, the tumour is confined to the prostate but is large enough to be felt during a rectal exam. There are often no symptoms.

Common Treatment Choices

Radical surgery and/or radiation therapy. Depending on the patient’s age and health, no treatment may be the best option.

T2bT2a

The tumour is often palpable and is limited to half of one lobe or less.

 

T2bT2b

The tumour may be palpable and has spread to more than half of one lobe but not to both lobes.

 

T2cT2c

The tumour is often palpable and has spread to both lobes.


Stage T3

Tumour Spread Outside the Prostate, High Risk of Metastases

In Stage T3, the tumour has spread to tissues touching, or adjacent to, the prostate. The seminal vesicles, the glands that produce semen, may have cancer in them. Difficulty in passing urine is a likely symptom. (However, this symptom is more likely due to BPH than prostate cancer.)

Common Treatment Choices

  • simple surgery (to improve passing of urine, called a transurethral resection or TUR)
  • radiation therapy
  • hormone therapy
  • a combination of these treatments

Depending on the patient’s age and health, no immediate treatment may be the best option.

T2bT3a

The tumour has spread outside the prostate on one lobe only.

T2bT3b

The tumour has spread outside the prostate on both lobes.

T2bT3c

The tumour has spread to one or both seminal vesicles.


Stage T4

Tumour Spread Outside the Prostate, Very High Risk of Metastases

In Stage T4, the tumour has spread to organs near the prostate, such as the bladder, rectum and the side wall of the pelvis. Bone pain, weight loss and tiredness are common symptoms.

Common Treatment Choices

  • simple surgery (to improve passing of urine, called a transurethral resection or TUR)
  • hormone therapy

Patients usually have symptoms at this stage, and treatment is required.

T4

The tumour has spread outside the prostate and seminal vesicles to nearby.


Stage N0

There is no evidence that lymph nodes have cancer cells in them.

Stage NX

It cannot be determined whether the lymph nodes have cancer cells in them or not.

Stage N1

One or more lymph nodes have cancer cells in them.

Stage M0

There is no evidence that cancer has spread into distant parts of the body.

Stage MX

It cannot be determined whether the cancer has spread into distant parts of the body or not.

Stage M1

The cancer has spread (metastasised) into distant parts of the body.