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What are the stages in prostate cancer?

introduction

Prostate cancer is also known as prostate cancer. It is one of the most common cancers in men. Around 60 thousand new cases are reported in Germany every year. The average age of onset is 70 years. 3 out of 100 men with prostate cancer die from the disease.

Overall, however, prostate cancer is one of the slow-growing tumors, so treatment can be carefully planned.

How many stages are there in prostate cancer?

The severity of prostate cancer is divided into 4 stages, 1 being the initial stage and 4 being the most advanced stage.

The classification is based on the TNM classification, which can be made after detailed diagnostics. The results of the digital rectal examination, the PSA value determination and the biopsy as well as other examinations (MRT, ultrasound, CT, PET scan, etc.) are compiled and the tumor is classified and assigned to a stage.

So-called tumor conferences or tumor boards are often responsible for this, in which doctors from various disciplines advise on the severity of the disease and the treatment options.

How are the stages divided?

Prostate cancer can be classified according to the clinical classification or the UICC stage (1 to 4). Both classifications are based on the TNM classification.

T describes the extent of the tumor, whereby the letters a-c are used for a more detailed definition,
N whether lymph nodes are involved and
M stands for distant metastases, where a-c delimit the location of the metastasis.

The most harmless would be e.g. T1aN0M0 and worst of all T4N1M1.

Clinically, between the

locally limited prostate cancer,
locally advanced prostate cancer and
differentiate from metastatic prostate cancer.

In addition, depending on the course of the disease and the speed of tumor growth, a distinction can be made between a low, medium and high risk profile. The various classifications partially overlap.

Internationally, the TNM classification applies above all.

Stage 1 prostate cancer

Stage 1 includes all tumors of the prostate that extend up to the TNM classification T2a. Often it is a chance finding, especially since those affected have no complaints.

In the early stages (T1a-c), the tumor is limited to the prostate and cannot be palpated and often cannot be recognized by imaging techniques. T2a means that the prostate cancer can be seen on imaging and occupies less than half of a side lobe. One also speaks of a “low risk tumor”.

Life expectancy is very high: over 75% of those affected survive who decide against curative therapy. Therapy is usually sufficient in the context of wait and see or active surveillance.

Surgical removal of the prostate is of course also possible to remove the tumor. Patients in the 1st stage often opt for this invasive method when immediate relatives have died of prostate cancer. As a rule, this is not necessary this early, especially since the intervention can cause permanent functional failures.

Learn more about this at: Therapy of prostate cancer

Stage 2 prostate cancer

Here, too, the tumor can only be found in the prostate tissue and has not broken through the capsule, but can be felt and clearly seen in the imaging.

According to the TNM classification, tumors T2b-c fall to stage 2. This means that more than half or both of a prostate lobe fell from the cancer. There is no lymph node involvement or metastasis in other organs.

In the 2ndIn the 2nd stage, removal of the prostate or other therapies such as radiation or chemotherapy may be considered. Life expectancy is quite good, but slightly lower than in the first stage.

also read: How do you treat prostate cancer?

Stage 3 prostate cancer

The 3rd stage includes the classification T3. The tumor has ruptured the prostate capsule and it may spread to nearby tissues such as come down the vas deferens. The tumor has a medium risk profile.

At this stage, patients often have symptoms. Typical complaints are

Urinary retention
Blood in the urine
Incontinence
impotence
Urinary congestion in the kidneys

Treatment depends on the patient's age and health. Curative (eliminating the cause of the disease) and palliative (relieving symptoms without eliminating the cause) therapies are possible.

Find out more at: Prostate Cancer Cure Chances

Life expectancy in stage 3

Life expectancy in the third stage depends largely on the general health of the person affected and the planned therapy.

About half of those affected die under purely palliative treatment. If aggressive growth is found in the course of time, then the survival time decreases, even if the majority of prostate cancers grow slowly.

Stage 4 prostate cancer

In the last stage there is at least a TNM classification of T4. The tumor has also spread to neighboring organs (such as the urinary bladder, rectum, pelvic wall, etc.). Clinically, one would still speak of locally advanced prostate cancer.

The tumor then has a high risk profile.

However, if the lymph nodes are also affected by cancer (T4N1M0) or metastases are found in organs further away (T4N1M1), it is an advanced or metastatic prostate carcinoma.

There may be other symptoms, such as

rapid weight loss
Pain in the bones
profuse sweating at night

continue reading: Metastases in prostate cancer

Life expectancy at stage 4

The tumor has already "spread" and affected other organs. Life expectancy is the worst, but it depends on the type of organ affected and whether removal or radiation or chemotherapy is possible. More than 75% of patients without curative intervention die at this stage.

Learn more at: Life expectancy in prostate cancer