StageGrouping of Prostate Cancer


Prostatecancer is ranked the second in the list of malignancies that affectmen, after the skin melanoma. The malignancy affects the prostate,but it spreads to other parts of the patient’s body with time. Thestage grouping system begins with the determination of the extent towhich the tumor has spread from the affected prostate. For example,the swelling may be within the tumor, spread to the lymph nodes, orto other organs. This classification is referred to as the TNMsystem. The information obtained from the TNM system is used todetermine the level of the cancer in the four-stage system thatstarts from phase I and ends with phase IV. Similar to the TNMsystem, the Roman numeral staging process is used to describe thesize and extent to which the malignancy has extended away from theaffected prostate. For example, stage I and II indicate that thetumor is quite small and it cannot be seen, even with the help of theimaging technology.

Keywords: Prostate cancer, TNM system, malignancy, stage grouping.

StageGrouping of Prostate Cancer

Prostatecancer is a medical condition that has been affecting men across theglobe. Prostate cancer is currently recorded as one of the leadingcauses of morbidity, with 14 million new cases and 8.2 million deathseach year, which has resulted in its classification as the mostcommon type of cancer affecting men after the skin malignancy(Feletto, Clark, Smith, Rasiah &amp Chalasani, 2015). However, onlyfour percent of the cases reach the metastasis stage (Hoffman, 2011).This paper provides the system for stage grouping of prostate cancer.

Prostatecancer is staged using the TNM system, which stands for the tumor,nodes, and the metastases phases. The T staging is used to explainthe extent to which the cancer has spread locally and it ranges fromT1 to T4. During the T1 phase, the health care provider can only seethe tumor with the help of imaging technology, such as the ultrasound(American Cancer Society, 2016). The T1 phase is further subdividedinto three other stages that include T1a (the tumor is less than 5 %of the tissue that is removed), T1b (more than 5 % of the removedtissue), and T1c (the tumor is identified by the needle biopsy) (ACS,2016).

Duringthe T2 phase, a doctor can identify the tumor using the digitalrectal exam or by performing an ultrasound. During T2a, the tumor isless than 50 % of the prostate, more than 50 % in T2b, and spread onboth sides of the prostate at the T2c stage (ACS, 2016).

Duringthe T3 phase, the tumor has spread to outer parts of the prostate,including the seminal vesicles. In T3a, the tumor has extended to theprostate, but it has not reached to the seminal vesicle (ASCO, 2016).In the T3b stage, the tumor has not affected the seminal vesicle.

TheT4 stage is characterized by a cancer that has reached tissues thatare adjacent to the prostate, including urethral sphincter, bladder,and rectum (ACS, 2016).

TheN categories are used to describe whether the growth has spread tothe lymph nodes and the nearby regions. This category is subdividedinto three groups including the NX (lymph nodes have not beenassessed), N0 (cancer has not yet reached the regions around thelymph nodes, and N1 (cancer has reached to at least one lymph node)(ASCO, 2016).

TheM categories are used to describe whether the growth has reacheddistant parts (including the bones, liver, and lungs) of thepatient’s body. M0 describes the growth that has not gone close tothe lymph nodes. In M1, the tumor has spread in the areas near thelymph nodes. M1a the growth as affected distant lymph nodes in M1bit has reached the bones and in M1c the tumor has infected otherorgans, including the liver, brain, and the lungs.

Thestage grouping

Theinformation about the T, N, and M categories is combined with PSAlevel and Gleason score in order to determine the overall phase ofthe cancer. The comprehensive phases are expressed in Roman numerals,including State I, II, III, and IV (ASCO, 2016).

StageI: At this stage, the tumor is located in the prostate only. Itcannot be identified with the help of imaging technology. The stagegroupings include T1a, T1b, T1c, N0, and M0 T2a, N0, M0 and T1, orT2a, N0, M0.

StageIIA and stage IIB: The phase describes a very small growth thatcannot be identified with the imaging technology. The swelling may beslightly larger and can be detected during the DRE. The growth hasnot extended to the prostate, but its cells appear to be abnormal dueto faster growth (American Society of Clinical Oncology, 2016). Theswelling has not reached the lymph nodes as well as the distantorgans. stage groupings for IIA include T1a, T1b, T1c, N0, M0 T1a,T1b, T1c, N0, M0 T2a, N0, M0 T2b, N0, M0 and T2b, N0, Mo. Stagegroupings for IIB include T2c, N0, M0 T1, T2, N0, M0 T1, T2, N0,M0.

StageIII: At this stage the growth has extend to the outer layer of thepatient’s prostate and the nearby tissues. The swelling may alsohave reached the seminal vesicle (ASCO, 2016). Stage groupings forstage III include T3a, N0, and the M0.

StageIV: This phase describes any growth that extends to other parts ofthe patient’s body, including the rectum, bladder, lungs, lymphnodes, and the liver (ASCO, 2016). Stage groupings for stage IVinclude T4, N0, M0 T options, N1, M0 T options, N options, M1.


Prostatecancer affect men and it occurs in different stages. The disease hasa complex stage grouping process. The classification system forprostate cancer is used to describe the extent to which the growthhas spread. The TNM system of stage grouping is applied to indicatewhether the tumor has gone beyond the prostate, lymph nodes, andother organs. However, the information obtained from the TNM systemshould be analyzed further to determine the extent to which thecancer has reached on the Roman numeral grouping scheme.


AmericanCancer Society (2016). Prostate cancer stages. ACS.Retrieved July 20, 2016, from

AmericanSociety of Clinical Oncology (2016). Prostate cancer stages. ASCO.Retrieved July 2016, from

Feletto,E., Clark, D., Smith, D., Rasiah, K. &amp Chalasani, V. (2015). Anexamination of prostate cancer trends in Australia, England, Canada,and USA: Is the Australian death rate too high? WorldJournal of Urology,1, 1-12.

Hoffman,M. (2011). Screening for prostate cancer. TheNew England Journal of Medicine,24, 1-7.