‘Staging’ refers to finding out how far the cancer has spread.
This is investigated in a number of different ways. Initially, at the digital rectal examination, the surgeon notes whether he or she can feel the tumour as a nodule or irregularity on the prostate, and if so, whether it extends beyond the prostate itself. This is referred to as clinical staging. However, the exact stage is not easy to determine from a clinical examination. Sometimes the number of biopsy cores with cancer in them is reported by the pathologist, and gives an indication of the extent of the cancer. If surgery is completed and the prostate removed, staging can be determined more precisely by pathological (using a microscope) examination of the prostate tissue and surrounding organs which have been removed. This is called pathological staging.
is used around the world to stage cancers which develop as tumours and metastasise. In the TNM system for prostate
cancer, the staging is as follows:
Low risk: Low grade, well differentiated tumour, Gleason score 2–6
Intermediate risk: Intermediate grade, moderately differentiated, Gleason score 7
High risk: High grade, poorly differentiated, Gleason score 8–10These risk categories are those adopted in the recently announced American Urological Association 2006 Clinical
Practice Guidelines for Localised Prostate Cancer and the National Cancer Control Network Practice Guidelines in Oncology vs
2.2005 Prostate Cancer.See localised prostate cancer guide.pdf
Clinical Practice Guidelines: Evidence-based information and recommendations for the management of localised prostate cancer, A report of the Australian Cancer Network Working Party on Management of Localised Prostate Cancer, NHMRC, Oct 2002.