Identifying the Stages of Prostate Cancer

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Prostate Cancer - Stage I to Stage IV

There are four stages of prostate cancer. Stage I is the earliest form of the disease and stage IV is the most advanced stage. It usually takes several years for the cancer to progress from stage I to stage IV. Here are the characteristics of each stage of prostate cancer:

  • Stage I - The cancer is localized within the prostate and is microscopic at this stage. It is not detectable by tests including the digital rectal exam or diagnostic imaging.
  • Stage II - The cancer cells have developed into a tumor that is detectable. It remains localized within the prostate.
  • Stage III - The cancer has spread beyond the prostate to nearby tissue. The seminal vesicles are usually the first to become affected by the spreading prostate cancer.
  • Stage IV - The cancer has spread to various parts of the body including the lymph nodes, bones, liver or lungs.

How is the Stage of Prostate Cancer Determined?

Doctors use a guideline to evaluate the progression of cancer. The TNM staging system is one such guideline that is based on the size of the tumor and the extent to which the cancer has spread. To accurately describe the stages of prostate cancer, the size of the affected area in the prostate must be determined. Then, the lymph nodes must be evaluated to determine if the cancer has spread there. Finally, other organs and bones are examined to see if the cancer has metastasized.

Diagnostic Tests for Staging Prostate Cancer

To determine the stage of prostate cancer, there are several diagnostic tests that can be performed. Usually, the first step is a biopsy of the prostate. If cancerous cells are found, the next step is to determine if the cancer has spread. The prostate specific antigen blood test can help determine the progression of the disease. There are several methods to examine the prostate including an MRI via a rectal probe, transrectal ultrasound and a digital rectal exam. The lymph nodes within the pelvis are examined for cancer cells through surgery, and a nuclear medicine bone scan can check for cancer cells in the bone. A CT scan of the abdomen can find cancer cells in organs.

Treatment Options

There are several treatment options for prostate cancer. Surgery and radiation therapy are effective ways to treat the disease. There are several surgical procedures that can be used depending on how the cancer has spread. The lymph nodes within the pelvis can be removed and the entire prostate gland can be removed. There are two types of radiation therapy that can be used to treat prostate cancer: external beam radiation and radioactive tumor seeding, also known as brachytherapy. Hormone therapy is used to treat prostate cancer in older patients and chemotherapy is reserved for advanced prostate cancer. These treatment options can have side effects, including erectile dysfunction and incontinence.


1. “Stages of Prostate Cancer.” WebMd.

2. “Prostate Cancer: Latest Treatments and Emerging Therapies.” WebMd.