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Assessment and staging of prostate cancer

 
An attempt will be made to stage the prostate cancer from the various tests and examinations.  The clinical "staging" is as follows :-
 
 
  • T. Primary Tumour
  • T0 - No tumour palpable
  • T1 - Tumour in one lobe of the prostate
  • T2 - Tumour involving both prostate lobes
  • T3 - Tumour infiltrating out of the prostate to involve seminal vesicles
  • T4 - Extensive tumour, infiltrating local structures
 
  • N - Nodal status
  • N0 - No nodes
  • N1 – one sided nodes
  • N2 - Bilateral nodes
  • N3 - Fixed regional nodes
  • N4 - Juxta regional nodes
 
  • M - Metastases
  • M0 - No metastases
  • M1 – Metastases
 
PSA and Staging
The clinician will also take great note of the PSA result, as PSA levels reflect the extent of spread of prostate cancer.  Thus, a PSA level of > 100 is generally thought to indicate that the prostate cancer has spread to involve organs such as lymph nodes or bones, and that the tumour is no longer confined to the prostate alone.
 
PSA levels of >15 also influence management decisions and many surgeons will not operate on a patient with PSA levels >15 as this indicates to them that there may be a strong possibility that surgery may not be successful.