Prostate Cancer: Stage

The Stage of a cancer refers to how far it has progressed. There are several different staging systems but the most commonly used is A, B, C, D. Within each stage there are sub- stages:

Stage A describes a cancer that is only found by elevated PSA and biopsy, or at

surgery for obstruction. It is not palpable on DRE. It is localized to the prostate. This type of cancer is usually curable, especially if it is a relatively low Gleason grade.

Stage B Cancer refers to a cancer that can be felt on rectal examination and is

limited to the prostate. Other tests, such as bone scans or CT/MRI scans, may be needed to determine this stage, especially if the PSA is significantly elevated or the Gleason grade is 7 or greater. Many Stage B prostate cancers are curable.

Stage C Cancer has already spread beyond the capsule of the prostate into local

organs or tissues, but has not yet metastasized or jumped to other sites. This stage is determined by Digital Rectal Exam, or CT/ MRI scans, and/or Sonography. The bone scan, and , if done, the Prostascint scan are negative. Some Stage C cancers are curable.

Stage D Cancer has already spread, usually to distant lymph nodes, bones or other

sites. This is usually determined by bone scan, Prostascint scan or other studies. Stage D cancer is not curable but is treatable

There has been discussion recently about a slightly different classification for planning of therapy of apparently confined prostate cancers: Low, intermediate or high risk.

Low risk comprises those prostate cancer that are low in volume, Stage A or B1/B2, with a Gleason Grade of 6 or less, and a PSA less than 11.

Intermediate risk requires Stage B3 or Gleason Grade 7 or PSA greater than 10.

High Risk includes those cancers B3 or greater, Gleason grade 7 or above and PSA greater than 10.