Stages of Prostate Cancer

AJCC Stage

Stage grouping

Stage description

I

cT1, N0, M0

Grade Group 1 (Gleason score 6 or less)

PSA less than 10

The doctor can’t feel the tumor or see it with an imaging test such as transrectal ultrasound (it was either found during a transurethral resection of the prostate (TURP) or was diagnosed by needle biopsy done for a high PSA) [cT1]. The cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1, and the PSA level is less than 10.

OR

cT2a, N0, M0

Grade Group 1 (Gleason score 6 or less)  

PSA less than 10

The tumor can be felt by digital rectal exam or seen with imaging such as transrectal ultrasound and is in one half or less of only one side (left or right) of the prostate [cT2a]. The cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1, and the PSA level is less than 10.

OR

pT2, N0, M0

Grade Group 1 (Gleason score 6 or less)

PSA less than 10

The prostate has been removed with surgery, and the tumor was still only in the prostate [pT2]. The cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1, and the PSA level is less than 10.

IIA

cT1, N0, M0

Grade Group 1 (Gleason score 6 or less)

PSA at least 10 but less than 20

The doctor can’t feel the tumor or see it with imaging such as transrectal ultrasound (it was either found during a transurethral resection of the prostate (TURP) or was diagnosed by needle biopsy done for a high PSA level) [cT1]. The cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1. The PSA level is at least 10 but less than 20.

OR

cT2a or pT2, N0, M0

Grade Group 1 (Gleason score 6 or less)

PSA at least 10 but less than 20

The tumor can be felt by digital rectal exam or seen with imaging such as transrectal ultrasound and is in one half or less of only one side (left or right) of the prostate [cT2a]. OR the prostate has been removed with surgery, and the tumor was still only in the prostate [pT2].The cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1. The PSA level is at least 10 but less than 20.

OR

cT2b or cT2c, N0, M0

Grade Group 1 (Gleason score 6 or less)

PSA less than 20

The tumor can be felt by digital rectal exam or seen with imaging such as transrectal ultrasound. It is in more than half of one side of the prostate [cT2b] or it is in both sides of the prostate [cT2c]. The cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1. The PSA level is less than 20.

IIB

T1 or T2, N0, M0

Grade Group 2 (Gleason score 3+4=7)

PSA less than 20

The cancer has not yet spread outside the prostate. It might (or might not) be felt by digital rectal exam or seen with imaging such as transrectal ultrasound [T1 or T2]. The cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 2. The PSA level is less than 20.

IIC

T1 or T2, N0, M0

Grade Group 3 or 4 (Gleason score 4+3=7 or 8)

PSA less than 20

The cancer has not yet spread outside the prostate. It might (or might not) be felt by digital rectal exam or seen with imaging such as transrectal ultrasound [T1 or T2]. The cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 3 or 4. The PSA level is less than 20.

IIIA

T1 or T2, N0, M0

Grade Group 1 to 4 (Gleason score 8 or less)

PSA at least 20

The cancer has not yet spread outside the prostate. It might (or might not) be felt by digital rectal exam or seen with imaging such as transrectal ultrasound [T1 or T2]. The cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1 to 4. The PSA level is at least 20.

IIIB

T3 or T4, N0, M0

Grade Group 1 to 4 (Gleason score 8 or less)

Any PSA

The cancer has grown outside the prostate and might have spread to the seminal vesicles [T3], or it has spread into other tissues next to the prostate, such as the urethral sphincter (muscle that helps control urination), rectum, bladder, and/or the wall of the pelvis [T4]. It has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1 to 4, and the PSA can be any value.

IIIC

Any T, N0, M0

Grade Group 5 (Gleason score 9 or 10)

Any PSA

The cancer might or might not be growing outside the prostate and into nearby tissues [any T]. It has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 5. The PSA can be any value.

IVA

Any T, N1, M0

Any Grade Group

Any PSA

The tumor might or might not be growing into tissues near the prostate [any T]. The cancer has spread to nearby lymph nodes [N1] but has not spread elsewhere in the body [M0]. The Grade Group can be any value, and the PSA can be any value.

IVB

Any T, any N, M1

Any Grade Group

Any PSA

The cancer might or might not be growing into tissues near the prostate [any T] and might or might not have spread to nearby lymph nodes [any N]. It has spread to other parts of the body, such as distant lymph nodes, bones, or other organs [M1]. The Grade Group can be any value, and the PSA can be any value.

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