Doctors use a staging system to describe the amount of cancer and the location of cancer in your body. Cancer staging can help determine how large a tumor has grown and if it has spread to other body parts. Knowing the stages of prostate cancer is essential for doctors to treat your cancer effectively and determine your chance of recovery. Here is everything you need to know about the basics of prostate cancer.
Symptoms of Prostate Cancer
Prostate cancer is most often slow growing. Cancer can remain within the prostate gland for many years and often goes undetected until symptoms occur. Common symptoms of prostate cancer include:
- Difficulty starting a stream of urine
- A weak or interrupted flow of urine
- Frequent urination
- Difficulty emptying the bladder
- Pain or burning with urination
- Blood in the urine or semen
- Painful ejaculation
- Pain in the back, pelvis, or hips that doesn’t go away
How is Prostate Cancer Detected?
General medical guidelines suggest that men over 50 should regularly participate in prostate cancer screening. There are two methods your doctor will discuss with you to screen for prostate cancer. The tests include a digital rectal exam and a protein-specific antigen lab test.
Digital Rectal Exam
During a digital rectal exam (DRE), your doctor will insert a lubricated, gloved finger into your rectum to feel the back side of your prostate. Your doctor will feel for lumps, enlargements, or hard areas that could indicate prostate cancer.
Protein Specific Antigen
Protein Specific Antigen (PSA) is a protein made by the prostate that can be measured in the blood with a lab test. If your PSA level is elevated, it can indicate prostate cancer. It is important to remember that PSA levels can rise due to inflammation within the prostate and do not immediately indicate that you have prostate cancer.
It is important to note that a PSA test should be done once in your 40s to get a baseline level, which is helpful for comparison as you start getting regular screenings at age 50.
Abnormal Prostate Cancer Screening Results
If your DRE or PSA test results are abnormal, your doctor will recommend further screening tests. If prostate cancer is suspected, your doctor will schedule a biopsy of your prostate to take a closer look at the cells.
After your biopsy, a pathologist will examine your sample, look for specific cancer patterns, and assign a score to the first and second most predominant cancer patterns. The two scores added together will determine the Gleason score. Gleason scores range from 6–10, 6 being the lowest grade cancer and 10 being the highest.
Stages of Prostate Cancer
If you have been diagnosed with prostate cancer, your doctor will describe the severity of cancer as stage 1, stage 2, stage 3, or stage 4. Here is a breakdown of each of the four stages of prostate cancer.
Stage 1
Stage 1 prostate cancer is localized to the prostate and has not spread. Stage 1 prostate cancer can be challenging to detect because it cannot be felt on a digital rectal exam and often does not cause a significant increase in PSA. The cancer is likely slow-growing if the PSA is less than 10 and the Gleason score is less than 6.
Stage 2
In stage 2 prostate cancer, cancer has not spread beyond the prostate but is more advanced than in stage 1. Stage 2 prostate cancer can be further broken into stage 2A and stage 2B. Stage 2A prostate cancer is found on only one side of the prostate, while stage 2B prostate cancer is found on both sides of the prostate.
Stage 3
Stage 3 prostate cancer has spread outside the prostate capsule and into other surrounding tissues. Stage 3 prostate cancer can also be called locally advanced prostate cancer.
Stage 4
In stage 4 prostate cancer, cancer has spread to distant body parts. Stage 4 cancer often invades nearby lymph nodes, the spine or pelvis, the bladder, the liver, or the lungs.
Prostate Cancer Treatment
Your doctor will recommend how to best treat your prostate cancer based on the cancer stage. At early stages, active surveillance may be all that is needed – you and your doctor monitor the cancer’s progress and only start treatment if needed.
Radiation therapy is a common treatment for prostate cancer that has not spread, and surgery to remove the prostate is another treatment option. In later stages of cancer, more advanced treatment options are available, including immunotherapy, hormone therapy, and chemotherapy.
A diagnosis of prostate cancer can be scary – partnering with a trusted expert can help. Schedule an appointment today!