Staging is a way of recording how far the cancer has spread. The most common method is the TNM (Tumour-Nodes-Metastases) system.

  • The T (tumour) stage measures the tumour.
  • The N (nodes) stage measures whether the cancer has spread to the lymph nodes.
  • The M (metastases) stage measures whether the cancer has spread (metastasised) to other parts of the body.

T stage (tumour)

The T stage shows how far the cancer has spread in and around the prostate. This is measured with a digital rectal examination (DRE). You might also have an MRI scan to confirm your T stage.

T1 

The cancer can’t be felt or seen on scans, and can only be seen under a microscope – localised prostate cancer.

T1 prostate cancer

 

T2

The cancer can be felt or seen on scans, but is still contained inside the prostate – localised prostate cancer.

T2 Prostate Cancer

 

T3

The cancer can be felt or seen breaking through the capsule of the prostate – locally advanced prostate cancer.

  • T3a The cancer has broken through the capsule of the prostate but has not spread to the seminal vesicles (which produce some of the fluid in semen).
  • T3b The cancer has spread to the seminal vesicles.

T3 Prostate Cancer

 

T4

The cancer has spread to nearby organs, such as the neck of the bladder, back passage, pelvic wall or lymph nodes – locally advanced prostate cancer.

T4 Prostate Cancer

N stage (nodes)

The N stage shows whether the cancer has spread to the nearby lymph nodes. Lymph nodes are part of your immune system and are found throughout your body. The lymph nodes in your groin are near the prostate and are a common place for prostate cancer to spread to.

The N stag is measured using an MRI or CT scan is used to find out your N stage. This stage will only be measured if the result is likely to affect your treatment options.

The possible N stages are:

  • NX      The lymph nodes were not measured
  • N0       No cancer cells can be seen in the lymph nodes
  • N1       The lymph nodes contain cancer cells

If your scans suggest that your cancer has spread to the lymph nodes (N1), it may either be treated as locally advanced or advanced prostate cancer. This may depend on several things, such as how far it has spread (M stage).

M stage (metastases)

The M stage shows whether the cancer has spread (metastasised) to other parts of the body, such as the bones. This is measured using a bone scan. Your doctor may offer you a bone scan if they think your cancer might have spread. Most men with localised prostate cancer won't need to have a bone scan.

  • MX The spread of the cancer wasn’t looked at, or the scans were unclear.
  • M0 The cancer hasn’t spread to other parts of the body.
  • M1 The cancer has spread to other parts of the body.

If you have a bone scan and the results show your cancer has spread to other parts of the body (M1), you will be diagnosed with advanced prostate cancer.

References

Updated: February 2014 | Due for Review February 2016

  • List of references  

    • Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, Mason MD, Matveev V, Mottet N, van der Kwast TH, Wiegel T, Zattoni F. Guidelines on prostate cancer. European Association of Urology 2013. Available at www.uroweb.org
    • National Institute for Health and Care Excellence. Prostate Cancer: Diagnosis and Treatment; Full Guideline 2014. Available from www.nice.org.uk