Staging explained by Roger Bacon.

Following the tests made by your GP and urologist — PSA, DRE, Biopsy (giving Gleason score) a CT, MRI and Bone scans - the level of aggressiveness of your cancer is estimated.

This next step, is called Staging, and takes all of the information that has been obtained and classifies the cancer according to how far it has spread. The ThM system is the most common method in use for predicting the stage of disease.

T stands for Tumour and signifies the extent of the cancer in — and adjacent to — the prostate gland.

N stands for Nodes (lymph nodes) and signifies whether the cancer has — or has not — spread to nearby lymph nodes.       

M stands for Metastasis, the medical term for cancer that has spread to other tissues or organs, such as the bone or the lungs.

Each letter has further sub divisions of numbers and letters that describe where your cancer is. The numbers range from 0 to 4 and represent the extent of the tumour. The letter following the number is from a to c and indicates some subtype of information. See chart below. The doctors need this to discuss your options fully. If you ask them what you’re staging is they will share all the letters and numbers with you. Many men find they don’t feel the need to know the staging

Stage - TX, TO, T1

TX - Primary tumour cannot be assessed
T0 - No evidence of primary tumour
T1 - Tumour is not clinically apparent
T1a - Tumour incidentally found in less than 5% of prostate sample
T1b - Tumour incidentally found in more than 5% of prostate sample
T1c - Tumour identified by needle biopsy

Stage - T2

T2 - Tumour palpable and confined to the prostate
T2a - Tumour involves half a lobe or less of the prostate
T2b - Tumour involves half a lobe or more of the prostate
T2c - Tumour involves both lobes of the prostate

Stage - T3

T3 - Tumour extends through prostate capsule
T3a - Tumour extends through one lobe of the prostate capsule
T3b - Tumour extends through both lobes of the prostate capsule
T3c - Tumour invades the seminal vesicles
 

Stage - T4

T4 - Tumour involves structures other than seminal vesicles
T4a - Tumour invades bladder neck, external sphincter or rectum
T4b - Tumour invades muscles and/or pelvic wall
 

Stage - N (regional Lymph Nodes)

NX - Nodes cannot be assessed
NO - No regional node metastasis
N1 - Single node metastasis - 2cm or less at largest point
N2 - Single node metastasis — 2 to 5cm at largest point or multiple
N3 - Metastasis larger than 5cm in any node
 

Stage - M (Distant Metastasis)

MX - Metastasis cannot be assessed
M0 - No distant metastasis
M1 - Distant metastasis
M1a - Distant Lymph node(s) involved
M1b - Bone(s) involved
M1c - Other site(s) involved

Common Treatment Options:

Watchful waiting is a common option. Prostatectomy or Radiotherapy may be chosen for Tic. Hormone therapy may be used before, during or after surgery or radiation.

 

 

Prostatectomy or Radiation.
Hormone therapy may be used before, during or after.Watchful Waiting may be an option.

 

Radiation therapy - a few men may have Prostatectomy, others rely on Watchful Waiting or Hormone therapy.

 

 

Hormone therapy is usually used to delay the progress of the disease.



 

Hormone therapy is commonly used to help avoid metastasis developing in the bones.    

 


 

Hormone therapy maybe used to reduce the growth rate. Chemotherapy is also maybe an option. Targeted radiotherapy maybe used, dependant on where the tumour has spread.

 

Reproduced with kind permission of Somerset Prostate Cancer Support Association

Other treatments are available more information about Staging and Treatments can be found on their website:

www.somersetprostatecancer.org.uk