Diagnosis of Prostate Cancer

How is prostate cancer diagnosed?

Doctors describe the growth and spread of prostate cancer in stages. Doctors use these stages as guides when choosing treatment options or offering prognoses to their patients.

Prostate cancer staging is based on a number of different factors, including prostate cancer screening tests such as a digital rectal exam or  prostate-specific antigen (PSA) test and imaging studies like bones scans, MRIs, CT scans, and trans-rectal ultrasounds.

Stages of Prostate Cancer

In order to determine the stage of a patient’s prostate cancer, most doctors start by using the TNM staging system, which helps describe different aspects of the cancer’s growth.

• T – the T category measures the size and extent of the Tumor
• N – the N category measures whether and how far the cancer has spread to the Lymph Nodes
• M – the M category whether the cancer has spread to other organs in the body (a process called Metastasis

The score for each of these categories is determined based on a pre-determined set of criteria. Your doctor cannot feel or see the tumor with a score of T1. A score of T3 means that the tumor has begun to grow outside of the prostate.

After calculating the TNM categories, doctors will combine the TNM score with the patient’s Gleason score and PSA levels assigning of a specific stage to the patient’s cancer.

Prostate cancer prognosis and survival rates can help give patients an idea of their chances of surviving the disease based on the stage and time of diagnosis. While some patients may find this information helpful, others may not want to know.

Stage-1 Prostate Cancer (I)

The tumor is non-detectable by an imaging test or a physical examination in this early stage of prostate cancer. Meaning, the cancer has not spread outside of the prostate. Discovery of prostate cancer at this stage is almost 80%, with a 5-year survival rate of almost 100%.

Stage-2 Prostate Cancer (Divided Into IIA and IIB Stages)

The tumor may or may not be detectable through a physical examination or imaging tests and still has not spread outside of the prostate. However, in stage-2 the cells have a higher Gleason score and may grow more quickly.

Stage-3 Prostate Cancer (III)

In this stage, the cancer has now spread beyond the prostate and may spread to the nearby seminal vesicles. This can include some stage-4 prostate cancers that, while they have other advanced indicators, still have not moved to other organs. As with local stage prostate cancers, the 5-year survival rate is nearly 100%.

Stage-4 Prostate Cancer (IV)

This is the last stage of prostate cancer and describes a tumor that has spread to other parts of the body, including the lymph nodes, lungs, liver, bones, or bladder. For these cancers, the 5-year survival rate is 29%.

Keep in mind that every case is different and that statistics such as these are only general guidelines. With advancements in prostate cancer treatment happening at a greater rate, your chances for surviving this disease are increasing.

In general, prostate cancer actually has a very high survival rate – one of the highest among all types of cancers. Because prostate cancer is often a slow moving disease, the majority of men diagnosed with prostate cancer will actually pass away from an unrelated cause.

General Prostate Cancer Survival Rate

According to the American Cancer Society:

• The relative 5-year survival rate is nearly 100%
• The relative 10-year survival rate is 98%
• The 15-year relative survival rate is 91%

Note: Relative survival rate means the percentage of patients who live [x] amount of years after their initial diagnosis.

Keep in mind, however, that because the compiled list figures are of cancers diagnosed up to 15 years ago, you may have an even greater chance of survival than these indicate due to advances in prostate cancer treatment technology