Prostate Cancer- Stages: PART 1

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 When cells in the prostate gland begin to grow out of control, prostate cancer develops. Only males have a gland called the prostate. It produces a portion of the fluid that makes up semen. The prostate is located in front of the rectum, which is the last part of the intestines. It is below the bladder, which is a hollow organ that stores urine. Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all of the tests are finished.

There are 2 types of staging for prostate cancer:


Clinical staging:  This is based on the Gleason score, the results of a prostate-specific antigen (PSA) test, and a digital rectal exam (DRE). For more information, see the section below titled "Gleason score for grading prostate cancer." The outcomes of these tests will assist in determining whether additional imaging procedures such as x-rays, bone scans, computed tomography (CT) scans, or magnetic resonance imaging (MRI) are required. If scans are required, they can provide the doctor with additional information to determine the clinical stage.


Pathologic staging: This is based on information discovered during surgery and the pathology, also known as the laboratory results of the prostate tissue removed during surgery. Most of the time, the surgery involves getting rid of the entire prostate and some lymph nodes. Pathologic staging can get more information from examining the removed lymph nodes.


Stage groups for prostate cancer


Doctors combine the T, N, and M information to say what stage the cancer is. Staging also includes the PSA level (see Screening) and Gleason score.


  • Stage I: In this early stage, cancer typically grows slowly. The tumor is so small that it cannot be felt and only covers half of one side of the prostate or less. The PSA level is low. The cancer cells appear to be normal cells.

  • Stage II: The tumor is found only in the prostate. PSA levels are medium or low. Stage II prostate cancer is small but may have an increasing risk of growing and spreading.

    • Stage IIA: The tumor is so small that it cannot be felt and only covers half of one side of the prostate. The cancer cells are well differentiated and PSA levels are medium. As long as the cancer cells are still well differentiated, this stage also includes larger tumors that are only found in the prostate.

    • IIB Stage: Only inside the prostate can be found the tumor, which may be large enough to feel during a DRE. The PSA score is moderate. The differentiation of the cancer cells is only moderate.

    • IIC Stage: Only inside the prostate can be found the tumor, which may be large enough to feel during a DRE. The PSA score is moderate. It's possible that the cancer cells are moderately or poorly differentiated.

  • Stage IIIA: The cancer has spread beyond the outer layer of the prostate into nearby tissues. It may also have spread to the seminal vesicles. The PSA level is high.

    • Stage IIIB: The tumor has grown outside of the prostate gland and may have invaded nearby structures, such as the bladder or rectum.

    • Stage IIIC: The cancer cells across the tumor are poorly differentiated, meaning they look very different from healthy cells.

  • Stage IV: The cancer has spread beyond the prostate.

    • Stage IVA: The cancer has spread to the regional lymph nodes.

    • Stage IVB: The cancer has spread to distant lymph nodes, other parts of the body, or to the bones.


Recurrent: Cancer that has returned despite treatment is referred to as recurrent prostate cancer. It could return to the prostate or to other parts of the body. A second set of tests will be performed to determine the extent of the cancer's recurrence if it occurs. Frequently, these scans and tests are comparable to the initial diagnosis.

Dr. Amit Ghosh is one of the best urologist and robotics uro-surgeon in Kolkata. After his return from the UK, he has been associated with various institutions including Wockhardt Hospital and Kidney Institute, Woodlands Hospital, Kothari Medical Center and Anandalok Hospital. Currently he is dedicated to his service to Apollo Gleneagles Hospitals, Kolkata. Currently he has developed a very well established and robust Urological presence in the campus of Apollo Gleneagles Hospitals, Kolkata. The practice takes care of all fundamental general Urological procedures, a vast multi-disciplinary Uro Oncology specialty, and also a comprehensive diagnostic and uro health check-up facility.

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