Stages of prostate cancer and symptoms in various stages

Medically Reviewed by Dr Sravya, MBBS, MS 


Prostate cancer stages

Prostate cancer is a big concern, especially for older men. It’s one of the most common cancers in men worldwide. That’s why it’s vital to know about it. We’re here to make it easy. We’ll guide you through the different prostate cancer stages and explain the signs that come with each stage.

This blog is like a map, helping you understand prostate cancer stages. We’ll start with the early stages, which are easier to treat. Then, we’ll talk about the advanced stages that need special care. We’ll also talk about the small changes in your body that could be signs of prostate cancer. Knowing these signs can help you catch it early and make smart choices for your health.

Table of Contents

The PSA (Prostate-Specific Antigen) and Gleason Score

What are their roles in Prostate Cancer?

The PSA (Prostate-Specific Antigen) and Gleason Score are essential tools in diagnosing and managing prostate cancer:

PSA (Prostate-Specific Antigen):

Use: PSA is a blood test that measures the level of PSA in the blood. It’s primarily used for prostate cancer screening and monitoring.

How It’s Used:

 Screening: A higher PSA level can be an early sign of prostate cancer, but it’s not definitive. Elevated PSA levels may prompt further tests.

Monitoring: After a prostate cancer diagnosis, PSA tests are used to track how treatment is working. A rising PSA level can indicate cancer progression.

PSA levels can be elevated for reasons other than cancer, such as prostate infections or benign prostate enlargement (BPH). False positives and false negatives can occur.

Gleason Score:

Use: The Gleason Score is a grading system that evaluates the aggressiveness of prostate cancer based on its microscopic appearance.

How It’s Used:

 Diagnosis: During a prostate biopsy, a pathologist examines the cancerous tissue and assigns a Gleason Score. Scores range from 6 (low-grade cancer) to 10 (high-grade cancer).

Treatment Planning: The Gleason Score helps doctors determine the best treatment approach. High Gleason Scores suggest more aggressive cancer.

The Gleason Score plays a significant role in predicting how the cancer is likely to behave and in selecting appropriate treatment options.

Both the PSA level and Gleason Score, when used together, provide valuable information for diagnosing and managing prostate cancer.

Now let’s discuss prostate cancer’s four stages.

Prostate Cancer Stages

Prostate cancer stages help in determining the extent and severity of the cancer. The most commonly used staging system for prostate cancer is the TNM system, which takes into account three key factors: tumour size and extent (T), lymph node involvement (N), and distant metastasis (M), which means it spreads to other body parts. Here are the four stages:

Stage I (T1 or T2, N0, M0):

In the first stage, cancer is small, present within the prostate, and hasn’t spread. Stage I typically indicates early, localized prostate cancer. It’s often associated with an excellent prognosis. It can be treated with active surveillance, surgery, or radiation therapy. It is the best treatment for prostate cancer in its early stages.

Stage II (T1 or T2, N0, M0):

In this stage, cancer is still within the prostate but may be larger or more aggressive.

It also represents localized prostate cancer. Treatment decisions are influenced by factors like the Gleason Score and PSA level. It can be treated by surgery, radiation therapy, or other.

Stage III (T3 or T4, N0, M0):

In stage III cancer has begun to spread outside the prostate into nearby tissues or structures. It indicates more advanced cancer. Treatment options may include surgery, radiation therapy, and sometimes hormone therapy. The choice depends on factors like the extent of spread and overall health.

Stage IV (Any T, N1, or M1):

In this, cancer has either spread to nearby lymph nodes (N1) or distant parts of the body (M1), such as bones, liver, or lungs. It represents advanced prostate cancer. Treatment aims to manage the cancer, control symptoms, and improve quality of life. Treatments may include hormone therapy, chemotherapy, radiation, or targeted therapies.

See the table below to understand the difference between prostate cancer stages and their subtypes:

StageSubtype What It Means CharacteristicsPSA LevelGleason Score
Stage IA1Cancer is only in the prostate.The small tumour inside the prostate. Hasn't spread outside the prostateLowLow to Moderate
Stage II2ACancer is only in the prostateLarger tumours might be more aggressive. Still within the prostate.Low to ModerateModerate
2BCancer is still in the prostate but is more advancedThe tumor has grown and maybe high-grade. Still inside the prostateModerate to HighHigh
2CCancer may be in nearby tissuesTumors might have invaded nearby structures. Still inside the prostate.HighHigh
Stage III3ACancer has started to spread nearby.Might involve nearby lymph nodes or structures. Moving outside the prostate.HighHigh
3BCancer is more advanced in the nearby areaMore extensive in nearby lymph nodes or structures. Moving outside the prostate.HighHigh
3CCancer has grown in the nearby areaMore invasive into nearby lymph nodes or structures. Moving outside the prostate.HighHigh
Stage IV4ACancer has grown and spread to nearby lymph nodes or structures.In nearby lymph nodes or nearby structures. May involve other areas.Moderate to HighHigh
4BCancer has spread to other different parts of the body.In distant organs or bones. May involve other areas.HighHigh

Prostate Cancer Symptoms: Common signs that need attention

Prostate cancer can develop without causing any noticeable symptoms, especially in its early stages. However, as the cancer progresses or becomes more advanced, some common symptoms may appear. It’s essential to remember that these symptoms can also be caused by non-cancerous conditions, so experiencing them doesn’t necessarily mean you have prostate cancer. If you notice any of these symptoms, it’s important to consult a doctor for a proper evaluation.

Some of the common songs of this condition include;

Urinary Changes

Prostate cancer can affect the urethra, leading to urinary problems such as:

Red Urine or Semen

Probably due to the blood in semen or urine causing a red color. Prostate cancer can cause blood to appear in urine or semen. If you notice this, it’s essential to get it checked by a doctor.

Erectile Dysfunction

It might be difficult to achieve or maintain erections in some men with advanced-stage prostate cancer.

Pelvic Discomfort

This can include pain or discomfort in the pelvic area, lower back, hips, or upper thighs.

Bone Pain

If prostate cancer spreads to the bones, it can cause bone pain, often in the spine, hips, and ribs.

Unintentional Weight Loss

Advanced cancer can lead to unintended weight loss and fatigue.

Survival Rate of People with Prostate Cancer

Stages of cancer play an important role in defining the survival rate of people with prostate cancer. By knowing the cancer stage of prostate cancer doctors can plan treatment and get an estimate of what might happen.

Doctors do this by looking at how many people with prostate cancer survive for at least five years after diagnosis compared to those without it. But remember, these are just statistics from years ago, and each person’s experience can be different.

Here’s a breakdown:

Localized: The cancer hasn’t spread beyond where it started. If it’s localized, then the survival rate is 100 percent for five years.

Regional: The five-year survival rate is 100%. Even if the cancer has spread to nearby tissues like lymph nodes.

Distant: The 5-year survival rate drops to about 34% if cancer has traveled far in the body.

In conclusion, we can say that the combined survival rate for prostate cancer in all stages is quite good, at 97.1%. Remember, these numbers are based on past cases, and individual experiences can vary. It’s essential to discuss your specific situation with your healthcare team for the most accurate information and guidance.

Life Expectancy in Final Prostate Cancer Stages

The life expectancy for individuals in the final stages of prostate cancer can vary widely depending on several factors, including the extent of cancer spread, overall health, age, and response to treatment. It’s crucial to understand that predicting an exact life expectancy can be challenging, and doctors usually provide estimates based on available information.

Life expectancy may get shorter in advanced stages such as stage IV. In these stages, prostate cancer has spread to different parts of the body apart from the prostate. For example, bones or other organs. However, many individuals with advanced prostate cancer can live for several years with appropriate treatment and care.

It’s essential to have open and honest discussions with doctors to understand the specific situation and to explore treatment options aimed at improving quality of life and managing symptoms.


In simple words, understanding the different prostate cancer stages and the signs that come with them is important. Prostate cancer can start small and not show any signs at first, so it’s tricky. But catching it early is super important.

You might not feel anything if you have it in the beginning. That’s why going to the doctor for check-ups is good. They can do some tests to find out if anything is wrong even if you don’t feel bad.

If you start to feel things like peeing a lot, or it hurts when you pee, or you see blood in your pee or sperm, or you’re having trouble in bed, those could be signs of prostate cancer. Also, if you have pain in your lower back, hips, or thighs, that could be a sign too, especially if it’s not going away.

Remember, if you notice any of these things, it’s a good idea to talk to a doctor. They can help figure out what’s going on and what to do next. The earlier they find it, the better the chances of fixing it.