Staging:

After the biopsy has been performed and malignant cells are indeed found the next step is the cancer will be Staged. What is Staging? Staging is a method that doctors use to describe :

• how big the tumor is if it has spread the lymph nodes
• if it has spread locally or to distant organs

Staging for prostate cancer is done by using one of two staging techniques. The most common staging system used is the TNM system or Tumor, Node, Metastases system. The second system used is the Jewett-Whitmore system where prostate cancer is classified first as stage A, B, C, or D. Stages A and B cancers are considered curable. Stages C and D are treatable, but their prognoses are not that good. A number is then assigned to describe specific conditions within each stage.

 

TNM System
The TNM (tumor, node, metastases) system stages are similar to those of the Jewett-Whitmore system, but with more specific alphanumeric subcategories.

Primary tumor (T)

TX	Tumor cannot be assessed
T0	No evidence of primary tumor
T1	Clinically not palpable or visible by imaging
T1a	Found incidental to other surgery; present in 5% or less of tissue
T1b	Found incidental to other surgery; present in 5% or more of tissue
T1c	Identified by needle biopsy
T2	Tumor confined within prostate
T2a	Involving half a lobe or less of prostate
T2b	Involving half a lobe
T2c	Involving both lobes
T3	Tumor extends through prostate capsule
T3a	Extends through one lobe
T3b	Extends through both lobes
T3c	Extends into seminal vesicles
T4	Involves structures other than seminal vesicles
T4a	Invades bladder neck, external sphincter, or rectum
T4b	Invades muscles and/or pelvic wall

Regional Lymph Nodes (N)

NX	Nodes cannot be assessed
N0	No regional node metastasis
N1	Single node metastasis, 2 centimeters (cm) or less at largest point
N2	Single node metastasis, 2 cm to 5 cm at largest point, or multiple nodes, no larger than 5 cm at largest point
N3	Metastasis larger than 5 cm in any node

Distant Metastasis (M)

MX	Metastasis cannot be assessed
M0	No distant metastasis
M1	Distant metastasis
M1a	Distant lymph node(s) involved
M1b	Bone(s) involved
M1c	Other site(s) involved

 

Grading :

Grading : Also along with Staging the tumor cells will be graded. What is Grading?

Grading is a comparison of the tumor cells to normal cells and a distinction is made on how far removed from normal the cancer cells are. Prostate cancer is graded with a special system called Gleason Grading in the United States. A grade of 1 thorough 5 is given to each of two samples taken from different parts of the tumor by putting the tumor cells under a high powered microscope and looking at them. The sum of the two are used to get a Gleason score.

Gleason scores of 2 to 4 indicate that the cells are well differentiated, meaning the tissue is not too abnormal; 5 to 7 moderately differentiated; 8 to 10 poorly differentiated. Higher scores suggest aggressive tumors that likely require aggressive treatment.

Grading is an important determining factor when a oncologist is making a decision on how to go about treating your specific cancer.

Once a tumor has be staged and graded a determination on the correct plan of action can be made by your primary oncologist along with a medical oncologist, surgical oncologist or radiation oncologist.