Prostate Cancer Stages
Stage of Prostate Cancer
PSA Level
What It Means
Stage 1
Less than 10
Cancer is only in the prostate, and the tumor is usually small.
Stage 2
10-19
Cancer is in the prostate, and the tumor is larger than stage 1.
Stage 3
20 or above
Cancer cells have spread beyond the prostate to nearby tissues.
Stage 4
Any value
Cancer has spread to farther areas of the body, such as the bones, liver, or lungs.
Stage 1 is the earliest stage of prostate cancer, when cancer cells are only in the prostate. There is no lymph node involvement or metastasis.
Symptoms: Stage 1 prostate cancer doesn’t usually cause symptoms.
Outlook: Many cases of prostate cancer are slow-growing and remain in stage 1 for years. The goal of treatment for stage 1 prostate cancer is to cure the cancer and achieve remission (a period with no signs or symptoms of cancer). Your doctor may recommend surgery.
Stage 2 cancer cells are only in the prostate, and the tumor is larger than in stage 1. A healthcare provider can usually feel a stage 2 tumor during a digital rectal exam. There is no lymph node involvement or metastasis.
Stage 2 prostate cancer includes the following subtypes:
- Stage 2A: The cancer is confined to the prostate gland or has been removed by surgery. The PSA score is at least 10 but less than 20.
- Stage 2B: The cancer has spread throughout the prostate gland but not beyond it.
- Stage 2C: The cancer has spread outside the prostate gland but has not reached nearby lymph nodes.
Symptoms: Possible symptoms of stage 2 prostate cancer include difficulty urinating and blood in the semen or urine.
Outlook: Stage 2 prostate cancer is treatable. Your doctor may recommend surgery and radiation therapy to remove the tumor or your entire prostate gland and ensure that all cancer cells have been destroyed. The five-year survival rate for localized prostate cancer (stage 1 or 2) is over 99%.
Stage 3 prostate cancer has spread outside of the prostate to nearby tissues, including the seminal vesicles, urethral sphincter, rectum, bladder, or other pelvic areas. It includes the following substages:
- Stage 3A: The cancer has spread throughout the prostate gland but has not spread beyond it. The PSA level is at least 20.
- Stage 3B: The cancer has spread outside of the prostate gland but has not reached the lymph nodes. The PSA can be any value.
- Stage 3C: This substage is similar to stage 3B. The cancer has spread to other areas of the body but has not reached the lymph nodes. The PSA can be any value.
Symptoms: Possible symptoms of stage 3 prostate cancer include problems urinating, blood in your urine or semen, erectile dysfunction, and pain.
Outlook: Treatment options for stage 3 prostate cancer may include surgery, radiation therapy, and hormone therapy. The 5-year survival rate for regional spread prostate cancer (stage 3) is over 99%.
Stage 4—also called metastatic prostate cancer—is the most advanced form of prostate cancer. It includes the following substages:
- Stage 4A: The cancer has spread to tissues near the prostate and the lymph nodes. The PSA level can be any value.
- Stage 4B: The cancer has spread to the lymph nodes and distant areas of your body, such as the bones, liver, or lungs.
Symptoms: Based on where the cancer has spread, symptoms may include erectile dysfunction, hip or back pain, weakness or numbness in your legs and feet, weight loss, and fatigue.
Outlook: Stage 4 prostate cancer is not curable, but treatment options are available to help reduce pain and improve quality of life. Possible treatment options include surgery, hormonal therapy, and bone treatments. The 5-year survival rate for metastatic prostate cancer is 37%.
Treatment options to help stop or slow the progression of prostate cancer may include:
- Active surveillance: In cases of prostate cancer that are small and unlikely to grow or spread, your doctor may recommend monitoring the tumor until it begins to grow.
- Surgery: People with early-stage prostate cancer may benefit from surgery to remove the cancerous tumor. If you have a more aggressive type of prostate cancer, your doctor may recommend surgery to remove the prostate gland and surrounding lymph nodes.
- Radiation therapy: Your doctor may recommend radiation therapy to shrink the tumor before surgery or to destroy any remaining cancer cells after surgery.
- Hormone therapy: For more advanced stages, your provider may recommend hormone therapy in addition to radiation therapy.
- Chemotherapy: Your provider may recommend chemotherapy with other treatments if your prostate cancer is advanced or has metastasized.
- Lifestyle factors: Physical activity, a diet rich in nutrients, and avoiding smoking may lower the risk of death from prostate cancer.
Throughout your treatment, you will likely have regular meetings with your healthcare team. These appointments may include physical exams, imaging tests, blood tests, and treatments. Your provider may also recommend getting emotional support from a therapist or a cancer support group.
Prostate cancer may affect your sexual health and function. Advanced prostate cancer may affect your ability to control your bladder and bowels. Your healthcare team can help you learn to manage these symptoms.
Prostate cancer has four stages. Stage 1 is curable with surgery to remove the tumor or prostate gland. Stage 2 cancer has spread throughout the prostate gland. Stage 3 prostate cancer has spread to nearby tissues, and stage 4 prostate cancer has spread to the lymph nodes and distant areas of the body.
