Staging
If the biopsy shows that you have cancer, your
doctor needs to learn the extent (stage) of the disease to
help you choose the best treatment. Staging is a careful
attempt to find out whether the tumor has invaded
nearby tissues, whether the cancer has spread and, if
so, to what parts of the body.
Some men may need tests that make pictures of the
body:
- Bone scan: The doctor injects a small amount of a
radioactive substance into a blood vessel. It travels
through the bloodstream and collects in the bones. A
machine called a scanner detects and measures the
radiation. The scanner makes pictures of the bones
on a computer screen or on film. The pictures may
show cancer that has spread to the bones.
- CT scan: An x-ray machine linked to a computer
takes a series of detailed pictures of your pelvis or
other parts of the body. Doctors use CT scans to
look for prostate cancer that has spread to lymph nodes and other areas. You may receive contrast material by injection into a blood vessel in your arm
or hand, or by enema. The contrast material makes
abnormal areas easier to see.
- MRI: A strong magnet linked to a computer is used
to make detailed pictures of areas inside your body.
The doctor can view these pictures on a monitor and
can print them on film. An MRI can show whether
cancer has spread to lymph nodes or other areas.
Sometimes contrast material makes abnormal areas
show up more clearly on the picture.
When prostate cancer spreads, it's often found in
nearby lymph nodes. If cancer has reached these nodes,
it also may have spread to other lymph nodes, the
bones, or other organs.
When cancer spreads from its original place to
another part of the body, the new tumor has the same
kind of abnormal cells and the same name as the
primary tumor. For example, if prostate cancer spreads
to bones, the cancer cells in the bones are actually
prostate cancer cells. The disease is metastatic prostate
cancer, not bone cancer. For that reason, it's treated as
prostate cancer, not bone cancer. Doctors call the new
tumor "distant" or metastatic disease.
These are the stages of prostate cancer:
- Stage I: The cancer can't be felt during a digital
rectal exam, and it can't be seen on a sonogram. It's
found by chance when surgery is done for another
reason, usually for BPH. The cancer is only in the
prostate. The grade is G1, or the Gleason score is no
higher than 4.
- Stage II: The tumor is more advanced or a higher
grade than Stage I, but the tumor doesn't extend
beyond the prostate. It may be felt during a digital
rectal exam, or it may be seen on a sonogram.
- Stage III: The tumor extends beyond the prostate.
The tumor may have invaded the seminal vesicles,
but cancer cells haven't spread to the lymph nodes.
- Stage IV: The tumor may have invaded the bladder,
rectum, or nearby structures (beyond the seminal
vesicles). It may have spread to the lymph nodes,
bones, or to other parts of the body.
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