Prostate Cancer Staging
The physician "stages" prostate cancer 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 discouaging. 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.
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Stage A
Very early and without symptoms; cancer cells confined to the prostate
A1
Well differentiated and slightly abnormal cancer cells
A2Moderately or poorly differentiated and abnormal cancer cells in several locations within the prostate
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Stage B
Confined to the prostate, but palpable (detectable by digital rectal exam) and/or detectable by elevated PSA
B0Confined to the prostate, nonpalpable; PSA elevated
B1Single cancerous nodule in one lobe of the prostate
B2Extensive, involvment in one or both prostate lobes
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Stage C
Cancer cells found outside the prostate capsule (membrane covering the prostate); spread confined to surrounding tissues and/or seminal vesicles
C1Extends outside the prostate capsule
C2Bladder or urethral obstruction
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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
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