Getting to Know the Stage of Prostate Cancer, from Beginning to End

2. Gleason (Score) Prostate Cancer

The stage of prostate cancer is also identified as the Gleason score. The Gleason score is an indicator to see the pattern of cancer cells in tissue samples. This system is determined by an X-10 score with the most common (primary) and second (secondary) characteristics.

The following are the Gleason score levels:

• Gleason X: The Gleason score cannot be determined.
• Gleason 6 or lower: Cancer cells look similar to healthy cells.
• Gleason 7: Cancer cells are somewhat similar to healthy cells.
• Gleason 8, 9, or 10: The cells are different from healthy cells.

The Gleason score levels are grouped into simpler grade groups, namely:

• Grades Group 1: Glaison 6
• Grades Group 2: Gleason 3 + 4 = 7
• Grades Group 3: Gleason 4 + 3 = 7
• Grades Group 4: Glaison 8
• Group 5 Grades: Gleason 9 or 10

This Gleason Grade Group is then used to determine the patient’s prostate cancer stage.

– Advertisement –

3. Prostate Cancer Stage with the TNM System

Doctors use the TNM system to determine the nature of tumor growth and spread in patients. The following is an explanation of what TNM staging is:

The grade of the primary tumor is determined by describing its size and location. If the tumor cannot be assessed, the stage is called TX.

If no tumor is found, the stage is T0. As the size increases and spreads, so does the T1, T2, T3, or T4 stage. In addition to the basic categories, doctors may use subcategories such as T1a or T1b to add information.

This determines whether the cancer has spread to lymph nodes near your bladder.

If the lymph nodes cannot be assessed, the stage is called NX. If no lymph nodes are affected, the stage is N0. If there is cancer in the gland, the stage is N1.

Cancer has spread to bones or other organs (M1) or not (M0). Doctors may also use subsets such as M1a for lymph nodes or M1b for bone, or M1C for other areas.

The results of the T, N, and M score indicators will be combined with other stages. There are 5 stages from stage 0 and stage I to IV (1 to 4). This stage will give an overview of the development of cancer cells so that it will be easier for doctors to make treatment and care plans.

Prostate Cancer Staging Grouping

Doctors combine the T, N, and M results with the Gleason score (grade) and PSA level in a process called stage grading.

Overall stages are expressed in Roman numerals from I (lightest stage) to IV (heaviest stage). Doctors use staging to help determine the best treatment for you.

Stage I

Stage I prostate cancer is usually slow growing. The patient may not be able to feel the tumor because it affects only one half of the prostate or less. The cells also look healthy like other cells.

• This cancer develops in the prostate, but has not spread beyond the prostate area.
• In most cases, the tumor cannot be felt on a digital rectal exam (DRE) or seen on imaging tests.
• Gleason score of 6 or less and PSA level of less than 10.
• These tumors are one-half the size or less on one side of the prostate.

Stage II

Stage II prostate cancer means:

• Tumor found in prostate, not spread to other tissues.
• Moderate or low PSA level.
• Cancer is small but still has the risk of spreading and developing.

Stage II prostate cancer is separated again into several levels categorized by A, B, and C. The following is an explanation:

IIA stage

• This cancer develops in the prostate, but has not spread beyond the prostate.
• Doctors may or may not feel the tumor during DRE or see it on imaging tests.
• The tumor may touch more than half of one prostate lobe but not involve both lobes.
• Gleason score of 7 or less and a PSA level of less than 20.

IIB stage

• This cancer develops in the prostate, but has not spread beyond the prostate area.
• Doctors may or may not feel the tumor during DRE or see it on imaging tests.
• The tumor can be in one or both lobes of the prostate.
• Tumors can have both Gleason and PSA scores at any grade.

IIC stage

• The tumor is in the prostate but may be quite large during the DRE or seen on imaging tests.
• PSA level is moderate.
• Cancer cells look different from healthy cells and may develop moderately or poorly.

Also Read: 8 Foods to Maintain Prostate Health, Men Must Know

Stage III

Stage III prostate cancer means:

• The cancer has spread beyond the prostate but has not made it to the lymph nodes or anywhere else in your body.
• Tumors can have both Gleason and PSA scores at any grade (likely to be high).

At this stage, indicated towards end-stage prostate cancer. Cancer cells tend to spread and grow rapidly. Stage III prostate cancer is divided into several more stages, namely:

Stage IIIA

• Cancer cells have spread beyond the prostate to nearby tissues.
• Cancer cells have a risk of spreading to the seminal vesicles, which are the glands at the back under the bladder.
• High PSA levels

Stage IIIB

• A condition in which cancer cells spread beyond the prostate gland and may spread to the bladder or rectal tissue.
• The tumor has a Gelason score of 8 or less and a PSA at any grade.

Stage IIIC

• Cancer cells have or have not spread beyond the prostate.
• The cancer has not spread to any of the meningeal lymph nodes.
• The tumor had a Gleason score of 9 or 10, and a PSA at any grade.

Also Read: Rarely Realized, These Are Symptoms of Prostate Infection in Men

Stage IV

End-stage prostate cancer means:

• The cancer has spread beyond the prostate to other tissues and is usually the lymph nodes, bone, liver, or lungs.
• Tumors can have both Gleason and PSA scores at any grade.

This is late-stage prostate cancer where the cancer has spread beyond the prostate. The spread and growth of cancer is fast. End-stage prostate cancer is divided into several more stages, namely:

IVA stage

• Cancer cells have or have not spread to tissues near the prostate.
• The cancer has spread to nearby lymph nodes but not far from the prostate.
• Grade Group Gleason and PSA can be at any level.

IVB stage

• The cancer has spread to lymph nodes far from the prostate, other tissues of the body, or to the bones.
• Cancer may not have spread to nearby lymph nodes or other lymph nodes.
• Grade Group Gleason and PSA can be at any level.

Also Read: Is it true that eating excess eggs can cause prostate cancer?

Metastasis or End Stage of Prostate Cancer

In theory, prostate cancer cells can spread to all organs of the body. However, in most cases, the most common spread of prostate cancer appears in the lymph nodes and bones.

Metastasis or spread of prostate cancer occurs when cells come out of the tumor in the prostate. Cancer cells can spread throughout the body through the lymphatic or circulatory system.

The spread of prostate cancer generally appears in the bones, lymph nodes, lungs, and liver.

In rare cases, the spread of prostate cancer cells can be found in the adrenal glands, brain, breast, eyes, kidneys, muscles, pancreas, salivary glands, and spleen.

About 50 percent of men diagnosed with prostate cancer will have the cancer spread. Finding cancer early and treating it sooner can lower the risk of spreading cancer cells.

If the cancer cells have spread, generally a person will feel various symptoms such as bone pain. The doctor will recommend that you undergo further tests and treatment to stop the cancer from spreading.