Prostate Cancer Staging

Prostate cancer is staged based on the tumor's size, the character of its cells, and the extent of metastasis. Two systems commonly are used for staging prostate cancer: the Jewett-Whitmore system and the TNM (tumor, node, metastases) system.

Jewett-Whitmore system

In the Jewett-Whitmore system, prostate cancer is classified first as stage A, B, C, or D. Stages A and B cancers are considered curable. Stages C and D are treatable, but their prognoses are discouraging. A number is then assigned to describe specific conditions within each stage. For example, a tumor classified as stage B1 is a single cancerous nodule confined to one lobe of the prostate.

Prostate Cancer Stage 1 Image
Click to enlarge the image.

Stage A—Very early and without symptoms; cancer cells confined to the prostate

  • A1: Well differentiated and slightly abnormal cancer cells
  • A2: Moderately or poorly differentiated and abnormal cancer cells in several locations within the prostate

Prostate Cancer Stage 2 Image
Click to enlarge the image.

Stage B—Confined to the prostate, but palpable (detectable by digital rectal exam) and/or detectable by elevated PSA

  • B0: Confined to the prostate, nonpalpable; PSA elevated
  • B1: Single cancerous nodule in one lobe of the prostate
  • B2: Extensive, involvement in one or both prostate lobes

Prostate Cancer Stage 3 Image
Click to enlarge image.

Stage C —Cancer cells found outside the prostate capsule (membrane covering the prostate); spread confined to surrounding tissues and/or seminal vesicles

  • C1: Extends outside the prostate capsule
  • C2: Bladder or urethral obstruction

Prostate Cancer Stage 4 Image
Click to enlarge image.

Stage D—Metastasis (spread) to regional lymph nodes, or to distant bones, organs (e.g., liver, lungs), and/or other tissues

  • D0: Metastatic, clinically localized, and showing elevated blood PAP levels
  • D1: Regional lymph nodes involved
  • D2: Distant lymph nodes, bones, or organs involve
  • D3: Metastatic disease after treatment

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 09 Jun 1998

Last Modified: 01 Oct 2015