Prostate Cancer Staging Staging of prostate cancer means determining how advanced is the cancer or how far the cancer has grown.  The more advanced the cancer, the higher the stage.  The following is a simplified table of prostate cancer staging: Stage I:         Cancer that cannot be felt during a rectal exam. It is usually discovered by biopsy or when surgery is done for a benign prostatic process. The cancer is confined to the prostate and occupies a small amount of the prostate. Stage II:         The cancer is more advanced, but still confined to the prostate. Stage III:         The cancer is beyond the outer covering or capsule of the prostate, possibly in the seminal vesicles. Stage IV:         The caner has spread (metastasized) to other organs:                  -Invading into bladder, rectum and/or pelvic wall                  -Spread to lymph nodes                  -Spread to other distant body parts such as bones, liver, brain TNM Staging A more detailed form of staging is TNM prostate cancer staging. The TNM staging system describes the extent of the primary tumor (T), the absence or presence of metastasis to nearby lymph nodes (N) and the absence or presence of distant metastasis (M).          Stage                        Description          T1                         Not palpable by DRE, confined to prostate          T1a                       Incidentally found on TURP Less than 5% tissue          T1b                       Incidentally found on TURP more than 5% of tissue          T1c                       Found by needle biopsy due to elevated PSA          T2                         Confined to prostate on DRE or prostatectomy          T2a                       Tumor involves half of one lobe or less          T2b                       Tumor involves more than half of one lobe          T2c                       Tumor involves both lobes                     T3                         Tumor through prostate capsule          T3a                       Tumor just beyond capsule on one side          T3b                       Tumor just beyond capsule on both sides          T3c                       Tumor invades seminal vesicle(s)          T4                         Tumor extends to adjacent organs          T4a                       Tumor invades bladder/external sphincter/rectum          T4b                       Tumor invades levator muscles/pelvic side wall          Node (N)                Regional (pelvic) lymph nodes          N0                          No lymph node (LN) metastasis          N1                          Tumor in one LN less than 2 cm          N2                          Tumor in one LN between 2-5 cm          N3                           Metastasis one or more LN more than 5 cm          Metastasis (M)        Tumor spread to distant sites          M0                           No distant metastasis          M1a                         Distant (non-regional) LN involvement          M1b                         Metastasis to the bones          M1c                         Metastasis to other distant organs (lung, Brain) Relationship between TNM Prostate Cancer Staging and Stage Categories I to IV:          Stage                 T                N                   M                 I                 T1               N0                M0                 II                T2               N0                M0                 III               T3                N0                M0                 IV               T4               N0-N3           M0-M1                                   Any T          N1-N3           M1