Prostate Cancer

Frequently Asked Questions

13. If prostate cancer is found, how do doctors describe how far the cancer has spread?

If cancer is found in the prostate, the doctor needs to stage the disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The doctor also needs to find out the grade of the cancer. The grade tells how closely the tumor resembles normal tissue.

There are four stages used to describe prostate cancer. Doctors may refer to the stages using Roman numerals I-IV or capital letters A-D. The higher the stage, the more advanced the cancer. Following are the main features of each stage.

Stage I or Stage A -- The cancer is usually too small to be seen on an X-ray and causes no symptoms. The doctor may find it by accident when performing surgery for another reason, usually an enlarged prostate. There is no evidence that the cancer has spread outside the prostate. A sub-stage, T1c, is a tumor identified by needle biopsy because of elevated PSA.

Stage II or Stage B -- The tumor is still confined to the prostate but involves more tissue within the prostate. The cancer is large enough to be found through a biopsy that is done because of a high PSA level. There is no evidence that the cancer has spread outside the prostate.

Stage III or Stage C -- The cancer has spread outside the prostate to nearby tissues. The person may be experiencing symptoms, such as problems with urination.

Stage IV or Stage D -- The cancer has spread to lymph nodes or to other parts of the body. There may be problems with urination, fatigue, and weight loss.