What stage is my prostate cancer?

The TNM classification describes the size and extent of the tumor as well as the spread of cancer cells in other organs. The classification into different stages is based on three criteria:

• the size and spread of the tumor in the prostate (T)
• Absence or presence of local or adjacent (regional) lymph node metastases (N).
• the presence of distant metastases (M)

Classification and significance of the TNM classification in prostate cancer

Primary tumor

T1: The tumor is neither palpable nor detectable by imaging techniques (ultrasound, MRI, CT).

• T1a: Incidental finding, less than 5% of tissue contains cancer cells
• T1b: Incidental finding, more than 5% of tissue contains cancer cells
• T1c: After an elevated PSA level, cancer cells were found in the biopsy

T2: The tumor is palpable or visible on ultrasound, but still confined to the prostate gland

• T2: The tumor is limited to less than half of one prostatic lobe
• T2b: The tumor occupies more than half of a prostatic lobe
• T2c: The tumor has invaded both prostatic lobes

T3: The tumor has already broken through the prostate capsule and grown into the connective tissue around the prostate or seminal vesicle

• T3: The tumor has spread outside the prostate gland
• T3b: The tumor has infiltrated the seminal vesicle

T4: The tumor has spread even further into neighboring organs such as the urinary bladder or intestine

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Lymph nodes

N0: The adjacent lymph nodes are tumor-free

N1: The adjacent lymph nodes are

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Metastases

M0: No metastases are present

M1: Metastases are present

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For example, T1 N0 M0 would mean a small tumor with no lymph node involvement and no metastases.