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The term "to stage" a cancer means to describe the evident extent of the cancer in the body at the time that the cancer is first diagnosed. The stage of a cancer helps doctors understand the extent of the cancer and plan cancer treatment. Results of the treatment of similar Gleason score prostate cancer found at the same or similar stage can help the doctor and patient to make important decisions about choices of treatment to recommend or to accept.
Cancer staging is first described using what is called a TNM system. The "T" refers to a description of the size or extent of the primary, or original, tumor. "N" describes the presence or absence of, and extent of spread of the cancer to lymph nodes that may be nearby or further from the original tumor. "M" describes the presence or absence of metastases -- usually distant areas elsewhere in the body other than regional (nearby) lymph nodes to which the cancer has spread. Cancers with specific TNM characteristics are then grouped into stages, and the stages are then assigned Roman numerals with the numerals used in increasing order as the extent of the cancer being staged increases or the cancer prognosis worsens. Prognosis is finally reflected by considering the patient's PSA score at presentation as well as their Gleason score in assigning a final stage designation.
The American Joint Commission on Cancer AJCC system for prostate cancer staging is as follows:
T designations refer to the characteristics of the prostate cancer primary tumor.
T1 prostate cancers cannot be seen on imaging tests or felt on examination. They may be found incidentally when surgery is done on the prostate for a problem presumed to be benign, or on needle biopsy for an elevated PSA.