The next thing that doctors consider to determine the stages of prostate cancer is the TNM classification. TNM stands for:
- Tumor – Where is the tumor located, and how big is it?
- Nodes – Has the tumor affected the nodes? If yes, what nodes and how many are affected?
- Metastasis – Has cancer spread to other parts? If yes, where and how much?
Doctors use various tests to arrive at the TNM classification. When all results are in, they will then ascertain the stage.
Stages of prostate cancer
Typically, there are no symptoms in prostate cancer stage 1. In fact, the doctor often doesn’t feel the tumor during routine DRE or see it in the ultrasound. At this stage, they are likely to find out through tests or incidentally for another concern.
Similarly, a tumor that can be felt during DRE or seen during an ultrasound can be classified under stage 1; that is if it affects half (or less than half) of one side of the prostate.
The patient’s PSA level is low; the Gleason score is 6 or less. Moreover, the tumor has not spread beyond the prostate.
Stage II prostate cancer is further divided into three subgroups: IIA, IIB, and IIC.
The doctor may or may not feel or see the tumor during exams, but cancer at this stage is generally confined in the prostate. Moreover, the Gleason scores typically increase as you move further into the subgroups.
It’s also worth mentioning that, while the tumor at stage II is small, it might have an increased risk of growing or spreading.
Like stage II prostate cancer, stage III has three subgroups: IIIA, IIIB, IIIC.
In stage IIIA, the tumor may not have spread outside the prostate, but at IIIB, it may have already extended to nearby structures such as the bladder or rectum.