After diagnosis of prostate cancer and before treatment, it is important to determine the stage and type of cancer. Understanding the development of a patient’s prostate cancer can help develop the most appropriate treatment plan. In this regard, this article will analyze the stages of prostate cancer and the different types of prostate cancer, which will help doctors evaluate diagnosis and treatment, and will be further introduced below.

Prostate cancer staging and grading system

According to Cancer Research UK, doctors will further introduce the following methods based on the data collected from prostate cancer patients.

1. Prostate cancer grading: What abnormalities the prostate cancer cells look like under a microscope.
   
2. Prostate cancer staging: the size of prostate cancer cells and whether they have metastasized.

There is also the digital installment method that we are more familiar with, and the order is as follows:

1. Stages 1 and 2 of prostate cancer are also called early stage prostate cancer or localized prostate cancer.
   
2. The third stage of prostate cancer is also called locally advanced prostate cancer.
   
3. Stage 4 prostate cancer is also called the final stage of prostate cancer.

Prostate cancer staging steps

There are three steps to consider when staging and grading prostate cancer, each of which is explained below.

Different from the Prostate-Specific Antigen (PSA) blood test used for prostate cancer screening, the PSA blood test used for prostate cancer staging uses cancer progression and treatment effect as the evaluation criteria. Its testing and follow-up are more frequent. In the early stages, physicians may evaluate the patient’s most recent PSA test or give a new PSA test.

Prostate cancer grading

After the physical examination, the pathologist will grade the prostate cancer. Currently, there are two main grading systems, as follows. Please note that the higher the grading score, the higher the risk of prostate cancer recurrence after treatment. On the contrary, the lower the grading score, the lower the risk of prostate cancer recurrence after treatment.

1. Gleason score: The most commonly used prostate cancer grading system, with scores ranging from 6 to 10.
   
2. Gleason score with the simpler Grade Group system: A grading system reformulated by the World Health Organization (WHO), with scores ranging from 1 to 5

Prostate cancer staging and metastasis

By following the TNM cancer staging system and comparing it with PSA blood tests and Gleason scores, physicians can gather a more comprehensive picture of prostate cancer progression for more professional treatment evaluation. It should also be noted that prostate cancer metastasis can be detected from lymph nodes and other organs or body parts. In addition, pathological staging and clinical staging may be different. If you have any questions, please consult your doctor.

Prostate cancer staging

1. Prostate cancer stage 1
   • Gleason grade 1 (score below 6), PSA level below 10.
     
   • Doctors cannot feel the tumor with palpation, cannot see the tumor through imaging examinations, and pathological sections cannot determine it to be a tumor (cT1). The cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0).
     
   • Tumors were found by digital anal examination or imaging examinations, and they only appeared in half or smaller of one side of the prostate (cT2a). cancer cell. The cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0).
     
2. Prostate cancer stage 2
   
   Issue 2a
   
   • Gleason grade 1 (score below 6), PSA level at least 10 but below 20.
     
   • Doctors cannot feel the tumor with palpation, cannot see the tumor through imaging examinations, and pathological sections cannot determine it to be a tumor (cT1). The cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0).
     
   • The tumor is detected by digital anal examination or imaging examination and appears in only half of the prostate or less (cT2a) on one side of the prostate. The cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0). The prostate has been surgically removed and the cancer is only in the prostate (pT2). The cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0).
     
   • Tumors were found during digital anal examination or imaging examinations, and had appeared in more than half of the unilateral prostate or on both prostates (cT2c). The cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0). PSA level below 20.
     
     Issue 2b
     
   • Gleason grade 2 (score 3+4=7), PSA level below 20.
     
   • The cancer cells have not spread beyond the prostate. Tumors (T1 or T2) may not be detected by digital anal examination and imaging studies. The cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0).
   • 
     Issue 2c
     
   • Gleason grade 3 or 4 (score 3+4=7 or 8), PSA level less than 20.
   • The cancer cells have not spread beyond the prostate. Tumors (T1 or T2) may not be detected by digital anal examination and imaging studies. The cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0).
     
     
3. Prostate cancer stage 3
   
   Issue 3a
   
   • Gleason scale 1 to 4 (score 8 or less), PSA level at least 20.
     
   • The cancer cells have not spread beyond the prostate. Tumors (T1 or T2) may not be detected by digital anal examination and imaging studies. Cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0)
     
     Issue 3b
     
   • Gleason scale 1 to 4 (score 8 or less), any PSA level.
   • Cancer cells have spread beyond the prostate and may have spread to the seminal vesicles (T3) or other paraprostatic tissues such as the urinary sphincter, rectum, bladder, or pelvis (T4). The cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0).
     
     Issue 3c
     
   • Gleason scale 5 (score 9-10), any PSA level.
     
   • Cancer cells may not necessarily have spread to adjacent tissues of the prostate (T1~4). The cancer cells have not spread to nearby lymph nodes (N0) or other parts of the body (M0).
     
4. Prostate cancer stage 4
   
   Issue 4a
   
   • Any Gleason grade, any PSA level.
     
   • The tumor may not necessarily have grown into adjacent tissue of the prostate (T1~4). The cancer has spread to nearby lymph nodes (N1) but has not spread to other parts of the body (M0).
     
     Issue 4b
     
   • Any Gleason grade, any PSA level.
     
   • The tumor may not necessarily have grown into adjacent tissue of the prostate (T1~4). Cancer cells have not necessarily spread to nearby lymph nodes (N1~4), but have spread to other parts of the body (M1).

Prostate cancer types

In addition to the most common alveolar adenocarcinoma, there are actually many types of prostate cancer, listed below:

1. Alveolar adenocarcinoma:
   Nearly all prostate cancers are alveolar adenocarcinomas (Acinar adenocarcinoma), which grow in cells lining the glands of the prostate.
   
2. Ductal adenocarcinoma:
   Ductal adenocarcinoma may grow and spread faster than alveolar adenocarcinoma and begins in the cells lining the duct glands of the prostate.
   
3. Transitional cell cancer:
   This type of prostate cancer usually starts in the cells that line the urinary ducts in the bladder and spreads to the prostate, but rarely, transitional cell cancer (also called urothelial cell cancer) Urothelial cancer) can start in cells lining the urethra of the prostate and then spread to the entrance to the bladder and adjacent tissues.
   
4. Squamous cell cancer:
   Squamous cell cancer grows and spreads faster or faster than adenocarcinoma and begins in the flat cells of the prostate.