Understanding Prostate Cancer: Stages of Prostate Cancer

If the biopsy shows that you have cancer, your doctor needs to know how advanced the disease is. This is called the stage. This is a way to find out whether:

  • The tumor has invaded nearby tissues.
  • The cancer has spread and, if so, to what parts of the body.

Your doctor may recommend one or more of the following tests:

Bone scan: In this procedure, your doctor injects a little bit of radioactive substance into the vein. It then travels through the bloodstream and collects in the bones. A machine called a scanner makes pictures of the bones. The radioactive liquid shows up cancer that has spread to the bones.

CT scan: A CT scan is an X-ray machine linked to a computer. It takes pictures of the pelvis or other parts of the body. Your doctor will use a CT scan to look for prostate cancer that has spread to lymph nodes or elsewhere. Before getting a CT scan, you may have contrast liquid injected into your veins. This process is uncomfortable but not painful. The contrast material makes any abnormal cells show up.

MRI: An MRI is a strong magnet linked to a computer. It takes detailed pictures of areas inside the body. Your doctor will use an MRA to tell if cancer has spread to lymph nodes or other areas.


There are two ways to evaluate the seriousness of prostate cancer:

  • Grading
  • Stages

The Gleason Score

In prostate cancer, tumors are graded. This means the doctor examines a tissue sample from your prostate under a microscope. Then that sample is graded according to how different it is from normal tissue. In general, the higher the grade, the more disorganized and aggressive the cancer is.

This grading predicts how fast the tumor is expected to grow.

If a tumor has a higher grade, it is likely to grow faster. It is also more likely to spread. One method of grading is called the Gleason score. Gleason scores range from 2 to 10. Here’s how the Gleason process works. The doctor looks at the patterns of cells in your prostate tissue. He or she gives the most common pattern a grade from 1 (most normal) to 5 (most abnormal).

Then the doctor looks at the next most common pattern of cells and “grades” it. The two scores are added together to make the Gleason score.

A low Gleason score means the tumor is slow-growing and not likely to spread quickly. This means that the lower the Gleason score, the slower the tumor

Staging is a way to describe the location of the tumor, or how far it spread.


Stage 1

The cancer cannot be seen on a sonogram or felt in a routine exam. Stage 1 prostate cancer is usually found when surgery is done for another reason. At this stage, the cancer is only in the prostate. This is a very early stage.

Stage 2

The tumor is more advanced. However, it is still contained to the prostate. It may be felt in an exam or seen on a sonogram

Stage 3

The tumor is not contained to the prostate. It may have invaded the seminal vesicles. However, the cancer cells have not spread to the lymph nodes.

Stage 4

The cancer has spread beyond the seminal vesicles. It may have invaded the bladder, rectum or other nearby sites. It also may have spread to lymph nodes, bones or elsewhere. This is an advanced stage.

Next: I’ve received my diagnosis. What do I do now? What questions do I need to ask my doctor? 

Back to “Understanding Prostate Cancer: An Introduction”