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Prostate cancer stages are used to indicate how advanced a patient’s cancer is and whether it has spread to other parts of the body. Staging is taken into consideration when developing a patient’s treatment plan, and it is also used to help estimate the prognosis.

The AJCC TNM staging system

  • The most commonly used method for staging prostate cancer is the AJCC (American Joint Committee on Cancer) TNM system. "TNM" stands for "tumor," "nodes" and "metastasis," which are among the factors used to determine the cancer's stage. The main influences considered when staging the cancer with the TNM system are:
  • The size of the primary tumor (T)
  • Whether the cancer has spread to nearby lymph nodes (N)
  • Whether the cancer has metastasized (M) to other areas of the body
  • The patient’s Gleason score (a number used to “grade” a cancer based on how it looks under a microscope)
  • The patient’s prostate-specific antigen (PSA) level

Staging prostate cancer

The stages are broken down as follows:

Stage 1

Stage 1 prostate cancer is limited to the prostate gland, which means that it has not spread to nearby lymph nodes or other areas of the body. Additionally, patients with cancer at this stage have a Gleason score of six or lower, and their PSA level is nine or lower.

Stage 2

Prostate cancer that is designated as stage 2 is still limited to the prostate gland and has not spread elsewhere. However, at stage 2, the patient’s Gleason score is a seven or higher and their PSA level is at least 10, but less than 20.

Stage 3

At stage 3, it’s possible that the cancer still hasn’t spread outside the prostate, but the PSA level is at least 20. Prostate cancer is also considered stage 3 when the cancer has spread beyond the outer layer of the prostate (for instance, it may have spread to the seminal vesicles or other tissues next to the prostate), but it has not spread to the lymph nodes. The patient’s PSA can be any level, and the Gleason score can be anywhere between two and 10.

Stage 4

Stage 4 prostate cancer has spread to nearby lymph nodes, tissues near the prostate, or even distant parts of the body, such as the bones or distant organs. Similar to stage 3, stage 4 prostate cancer can involve any PSA levels and Gleason scores that range between two and 10.

Treatment for prostate cancer at Moffitt Cancer Center

When a patient turns to Moffitt Cancer Center for diagnosis or treatment, we provide them with an individualized treatment plan that a multispecialty team of experts carefully assembles based on a comprehensive range of factors. We understand that prostate cancer stages are just a small part of the big picture; our oncologists evaluate everything from the stage and cellular makeup of the cancer to the patient’s overall health and personal preferences, and then tailor a treatment plan to fit the patient’s unique situation.

Medically reviewed by Monica Chatwal, MD.

No referral is required to come to Moffitt. You can request an appointment online or call 1-888-663-3488, and we’ll set up a time for you to meet with one of our oncologists specializing in prostate cancer.