How Prostate Staging Helps Your Doctor Evaluate Treatment Options
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To help evaluate possible treatments, most cancers are staged by a doctor, or put into a category describing how far they have spread. While prostate cancer is generally a slower-growing disease, once it has spread outside the prostate, known as metastasized cancer, it quickly becomes dangerous. First it attacks the local lymph nodes. Then it spreads to other lymph nodes throughout the body, and finally invades major organs. After it spreads, the first major organ it attacks is usually the bones. The most common scale used for staging is the TNM scale. T stands for tumor, N stands for lymph nodes, and M stands for metastasize. Through a combination of various tests, the doctor will assess the spread and label it accordingly:
From T1, the cancer is confined to the prostate, through T4, the cancer has spread outside the prostate. From N0, the cancer has not spread to the local lymph nodes, through N1, the cancer has spread to the local lymph nodes. From M0, the cancer has not spread to distant locations, through M1, the cancer has spread to distant bodily locations.
Along with staging, the cancer can also be graded. Cancer cells can often mimic local normal cells and are graded according to how closely or not they do. Grading is as follows:
From G1, the cancer cells mimic normal cells, through G4, the cancer cells are noticeably different from normal cells.
These four numbers are then used for general staging of the cancer:
T1, N0, M0, and G1 equals Stage I, or early stage cancer confined to a small portion of the prostate. T2, N0, M0, and G2 to G4 equals Stage II, or early stage cancer that has spread throughout a larger portion of the prostate. T3, N0, M0, and any G equals Stage III, or cancer that has spread completely though the prostate capsule, but not yet outside the prostate. T4, any N, any M, and any G equals Stage IV, or cancer that has left the prostate to invade other organs, either nearby or distantly.
Once the cancer is staged, the doctor can better judge treatment options and aggression. However, age and other risk factors are usually taken into account. For instance, even in more advanced stages some doctors may discover a lower risk in a patient and only prescribe radiation treatment and not hormonal treatment. Or vice versa. Staging only gives a good overall snapshot of the cancer and it’s immediate danger.
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