The Stages of Prostate Cancer: What You Need to Know

After a prostate cancer diagnosis, your oncologist will refer to the stage of your cancer. All cancers are categorized into four distinct stages, each of which identifies the progress of the growth of cancerous cells within clinically defined standards. These stages help doctors determine the most appropriate care for each patient based on his or her condition, and can also provide easy-to-understand context for your diagnosis. Learn more about the stages of prostate cancer, how each stage will affect your treatment plan and the survival rates for each stage, then contact Regional Cancer Care Associates (RCCA) to schedule a consultation.

Doctor With Clipboard

Overview of the Staging System

After a thorough assessment by your oncologist, your cancer will be assigned a stage between I and IV. Prostate cancer stages are based on the American Joint Committee on Cancer (AJCC) TNM system. Using the TNM system, your oncologist:

  • Examines the tumor (T)
  • Determines if the cancer has spread to any lymph nodes (N)
  • Assesses whether the cancer has metastasized (M)
  • Considers the prostate-specific antigen (PSA) level from blood testing
  • Assigns a grade group based on how abnormal the cancer appears under a microscope

With this information in mind, you can better understand how stages are assigned and what they mean for patients in general.

Prostate Cancer Stages

Stage I

Stage I prostate cancer is the earliest stage. At this point, the tumor is only in the prostate gland and is very small and slow-growing. Most patients don’t yet notice any symptoms or health problems. In some cases, the doctor may not even be able to feel the tumor during a digital rectal exam or see it with ultrasound. Patients with this stage of cancer have the best chances of cure and survival.

  • Grade Group: 1
  • PSA Level: Less than 10 or between 10 and 20
  • Initial Treatment Options: active surveillance, radiation therapy, radical prostatectomy
  • 5-Year Relative Prostate Cancer Survival Rate: Nearly 100%

Stage II

If left to grow, the tumor will eventually progress into stage II. A stage II tumor is bigger than a stage I tumor. Doctors will be more likely to recommend surgery or radiation, because if not treated, stage II cancer could continue to grow or spread to other areas of the body. There is also a greater chance of the cancer coming back after treatment (known as “recurrence”), so continued surveillance and regular checkups are necessary.

  • Grade Group: 1 (IIA), 2 (IIB), 3 (IIC)
  • PSA Level: At least 10 but less than 20
  • Initial Treatment Options: Active surveillance, radiation therapy, radical prostatectomy, clinical trial
  • 5-Year Relative Prostate Cancer Survival Rate: Nearly 100%

Stage III

In stage III, the cancer has started to spread and is no longer only affecting the prostate gland. Now, it may also be in the patient’s nearby tissues, lymph nodes, or distant organs. Because it has spread, stage III cancer typically requires more aggressive treatment. The risk of recurrence also increases.

  • Grade Group: 1 to 4 (IIIA, IIIB), 5 (IIIC)
  • PSA Level: At least 20 (IIIA), any PSA (IIIB, IIIC)
  • Initial Treatment Options: Active surveillance, radiation therapy plus hormone therapy, radical prostatectomy, clinical trial
  • 5-Year Relative Prostate Cancer Survival Rate: Nearly 100%

Stage IV

When a patient is diagnosed with stage IV prostate cancer, it means the cancer has already spread to nearby areas, particularly the bladder or rectum. It may have also spread to the lymph nodes, bones, lungs, liver, and other distant organs. As a result, only a small percentage of stage IV cancers can be cured and the 5-year survival rate decreases drastically. Doctors will focus treatment on controlling the cancer and making the patient as comfortable as possible.

  • Grade Group: Any grade group
  • PSA Level: Any PSA
  • Initial Treatment Options: Active surveillance, hormone therapy, chemotherapy, radiation, radical prostatectomy, surgery to relieve symptoms, clinical trial
  • 5-Year Relative Prostate Cancer Survival Rate: Nearly 30% (distant stage IVB cancer)

Learn More about Prostate Cancer Care at RCCA

If you’ve been diagnosed with prostate cancer or are concerned about potential symptoms, contact RCCA today. Our team of cancer care specialists will assess the stage of your cancer using the latest diagnostic methods and work with you to design a fully individualized care plan that includes advanced treatment options, the potential for clinical trials, and support that addresses physical and emotional well-being. To speak with a representative right away, please call 844-474-6866.