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Prostate Cancer

Stages of Prostate Cancer

Prostate cancer staging; six panel drawing showing a side view of normal male anatomy and closeup views of Stage I, Stage IIA, Stage IIB, Stage III, and Stage IV showing cancer growing from within the prostate to nearby tissue and then to lymph nodes or other parts of the body.

 

Stage I

In stage Icancer is found in the prostate only. The cancer:

  • is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 10 and the Gleason score is 6 or lower; or
  • is found in one-half or less of one lobe of the prostate. The PSA level is lower than 10 and the Gleason score is 6 or lower; or
  • cannot be felt during a digital rectal exam and cannot be seen in imaging tests. Cancer is found in one-half or less of one lobe of the prostate. The PSA level and the Gleason score are not known.

Stage II

In stage IIcancer is more advanced than in stage I, but has not spread outside the prostate. Stage II is divided into stages IIA and IIB.

In stage IIA, cancer:

  • is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 20 and the Gleason score is 7; or
  • is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or
  • is found in one-half or less of one lobe of the prostate. The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or
  • is found in one-half or less of one lobe of the prostate. The PSA level is lower than 20 and the Gleason score is 7; or
  • is found in more than one-half of one lobe of the prostate.

In stage IIB, cancer:

  • is found in opposite sides of the prostate. The PSA can be any level and the Gleason score can range from 2 to 10; or
  • cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA level is 20 or higher and the Gleason score can range from 2 to 10; or
  • cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA can be any level and the Gleason score is 8 or higher.

Stage III

In stage IIIcancer has spread beyond the outer layer of the prostate and may have spread to the seminal vesicles. The PSA can be any level and the Gleason score can range from 2 to 10.

Stage IV

In stage IV, the PSA can be any level and the Gleason score can range from 2 to 10. Also, cancer:

  • has spread beyond the seminal vesicles to nearby tissue or organs, such as the rectumbladder, or pelvic wall; or
  • may have spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. Cancer has spread to nearby lymph nodes; or
  • has spread to distant parts of the body, which may include lymph nodes or bones. Prostate canceroften spreads to the bones.

Adapted from the National Cancer Institute's Physician Data Query (PDQ(r)) Cancer Information Summaries (http://www.cancer.gov/cancertopics/pdq). Date last modified: September 12, 2014

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Last Reviewed: Mar 10, 2015