Prostate Cancer Staging

Prostate Cancer Specialists Los Angeles, CA

Early detection of prostate cancer is key to retaining a healthy, functioning body. At Comprehensive Urology in Beverly Hills, we conduct many early detection tests such as a PSA test in our state-of-the-art facilities to quickly diagnose and treat your condition.

Prostate cancer is one of the most common cancers affecting men worldwide. In fact, The National Cancer Foundation estimates that up to 25% of men may develop prostate cancer. Understanding its progression and potential outcomes is crucial for informed decision-making. Proper diagnosis is essential to ensure that you don’t have another common condition called Benign Prostatic Hyperplasia or BPH which is not cancer.

Whether you’re a patient, caregiver, or simply seeking knowledge on this topic, our team at Comprehensive Urology in Beverly Hills, Los Angeles, our aim is to equip you with the necessary information to navigate this complex landscape. Dr. Kia Michel offers prostate cancer screening, second opinions, and state-of-the art prostate cancer treatment modalities including the latest clinical trials. To learn more, please contact us or book an appointment online.

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Kia Michel, MD

Kia Michel, MD

Written by Dr. Kia Michel, a board certified urologist, surgeon, and founding member of Comprehensive Urology in Beverly Hills, Los Angeles. Dr. Michel's expertise includes focal therapy (HIFU/TULSA), prostate cancer treatment, robotic surgery, and male enhancement treatments such as Shockwave Therapy for ED and penile injections.

Dr. Michel's Bio

You may already be experiencing signs of prostate cancer or perhaps you recently had an elevated PSA result. Getting an accurate diagnosis is empowering in that know what is happening in your body gives us options to treat it. It’s important to rule out other conditions that have similar symptoms to prostate cancer like non-cancerous BPH.  In this article, we will delve into the various stages of prostate cancer, highlighting the key characteristics and implications of each stage. Additionally, we will explore survival rates associated with different stages, providing valuable insights into prognosis and treatment options.

Stay tuned as we unravel the intricacies of prostate cancer stages and shed light on survival rates to empower and support your health journey.

How is Prostate Cancer Diagnosed?

Diagnosing prostate cancer requires multiple test results conducted by a board certified urologist for accuracy. The most common methods used to determine the presence of prostate cancer, and to determine the staging of prostate cancer, are:

  1. Prostate Specific Antigen (PSA) blood test

  2. Prostate Exam

  3. Prostate Biopsy Procedure

PSA levels

The PSA (Prostate Specific Antigen) test is a blood test used to screen for prostate cancer by measuring the levels of PSA in the blood.

PSA is a protein produced by the prostate gland. PSA is found in both normal and cancerous prostates. Thus, while an elevated PSA level can suggest the presence of prostate cancer, it is not enough to definitively diagnose the disease alone.

A PSA level above 4 mg/L typically prompts further testing. If the PSA levels are above 100 ng/mL, the likelihood of prostate disease increases to 50%.

Early detection is key to surviving prostate cancer, which is why having a PSA each year after age 40 is highly recommended. While many physicians use the PSA test for detecting prostate cancer, there are ongoing debates regarding its effectiveness as a screening tool. Therefore, consulting with a qualified urologist is crucial for proper evaluation and diagnosis.

Prostate Exam

A prostate exam, also known as a digital rectal examination (DRE), plays a crucial role in the diagnosis of prostate cancer. It is a simple, quick procedure that allows healthcare providers to assess the prostate gland for abnormalities and potential signs of cancer. During a prostate exam, the doctor or healthcare professional inserts a gloved, lubricated finger into the rectum to feel the prostate gland. The healthcare provider can evaluate the size, shape, and texture of the prostate gland, searching for any irregularities that may indicate the presence of prostate cancer, such as lumps, hard areas, or changes in texture.

Prostate Biopsy Procedure

A prostate biopsy is typically performed after suspicious findings from other tests, such as an abnormal prostate exam or elevated prostate-specific antigen (PSA) levels.

During a prostate biopsy, a healthcare professional inserts a thin needle through the rectum or the area between the scrotum and anus (perineum) to access the prostate gland. The needle is guided by ultrasound imaging to ensure accurate targeting of specific areas of concern. Tissue samples are then taken from different regions of the prostate.

The collected tissue samples are sent to a laboratory, where a pathologist examines them under a microscope to determine if cancer cells are present. The biopsy results provide information about the aggressiveness of the cancer, including the grade and stage, which can guide treatment decisions.

Prostate biopsies are generally performed on an outpatient basis and may cause some discomfort or mild pain. Local anesthesia is typically used to numb the area and minimize discomfort during the procedure. Some men may experience temporary side effects such as blood in urine or semen, mild pain, or light rectal bleeding, which usually resolve within a few days.

What are the Stages of Prostate Cancer?

Doctors use results obtained from the above tests for diagnosis and treatment of prostate cancers. The most common system used to rate the progression of prostate cancer uses four stages based on how far the cancer has spread throughout the body.

  • Stage I – Prostate cancer is limited to a small area of the prostate and is not detectable during a rectal exam. This stage of prostate cancer is usually discovered through biopsy or during surgery for a non-cancerous prostate issue like BPH (Benign Prostatic Hyperplasia).

  • Stage II – Prostate cancer has progressed to more of the prostate, often encompassing both lobes of the prostate gland, but it has not yet spread beyond the prostate itself. The tumor is more likely to be felt during a prostate exam.

  • Stage III – Prostate cancer has spread beyond the outer layer of the prostate gland and may have affected the seminal vesicles and/or lymph nodes.

  • Stage IV – Prostate cancer is the most advanced stage, where the metastatic cancer has spread to other organs, such as the bladder, rectum, pelvic wall, and distant body parts, including bones, liver, and brain.

TNM Staging System for Prostate Cancer

The TNM staging system is a more detailed method of staging prostate cancer, which takes into account the size and location of the primary tumor (T), the presence of cancerous cells in nearby lymph nodes (N), and the spread of cancer to other distant organs (M). It is also called the Three-Stage Medicinal Cancer Screening System, and it focuses on the spread of cancer beyond the localized Stages (I and II) to the more advanced forms of prostate cancer in Stage III (regional) and Stage 4 (metastatic to other parts of the body).

What is a Gleason Score for Prostate Cancer?

The Gleason Score is a rating scale using the numbers 2-10 to indicate how aggressive the prostate cancer may be. While the 4-stage prostate cancer system and 3-stage TNM system both focus on how far the cancer has spread throughout the body, the Gleason Score is determined by a pathologist, who looks at slides of a prostate biopsy to determine how fast the cancer will progress. The Gleason Score is an estimate of the speed of the prostate cancer growth.

On the Gleason Scale, a lower number indicates cancer that is slow growing and less likely to spread. A higher score, such as a seven or above, indicates a more aggressive form of cancer that will grow faster and is considered high risk. A Score of 10 is regarded as a high-grade prostate tumor, which means it is more likely to metastasize, or spread outside the prostate gland to other parts of the body.


Survival Rate and Prognosis for Prostate Cancer

Prostate Cancer is the 2nd most occurring cancer in men worldwide. Early detection is key to increasing your survival rates for prostate cancer.

Learn more about prostate cancer screening and consider scheduling a PSA at Comprehensive Urology in Beverly Hill, Los Angeles. Schedule Your Appointment Today. Here are the survival rates for both early-stage and advanced prostate cancer.

Survival Rate for Prostate Cancer Stages I, II, and III

Survival Rates for local (Stages I and II) and regional (Stage III) combined are between 80-85%. The earlier the detection, the higher the survival rate, with early-stage prostate cancer (Stages I and II) having a survival rate of approximately 97%. The majority of men diagnosed and treated at the local or regional stages will be disease-free after five years. Early detection is the greatest factor in determining your survival rate, which is why getting an annual PSA test is crucial.

What is the Survival Rate for Stage IV Prostate Cancer?

Prostate cancers detected at stage IV have already metastasized (spread) to other areas of the body, such as the lymph nodes, surrounding organs, and brain. At this stage, survival rates decrease significantly. Stage 4B prostate cancer is the most advanced form and has the lowest survival rate of all other stages.

If you receive a diagnosis of advanced prostate cancer, be sure to get a second opinion from a board certified urologist to ensure that you are getting the latest treatment options, including a combination of therapies, as well as to learn about new clinical trials.

What is the life expectancy of a man with prostate cancer?

Due to early screening methods and the high curability of prostate cancer, the long-term outlook for those diagnosed is generally positive.

The American Cancer Society provides figures that show the average relative survival rates for all men with prostate cancer. These rates indicate a patient’s likelihood of survival after a certain number of years, compared to the general population’s survival rate during the same period. It is important to note that these rates apply to all stages of prostate cancer and cannot accurately predict an individual’s prognosis.

According to the American Cancer Society:

  • Five years after diagnosis, the 5-year relative survival rate is nearly 100 percent. This means that the average prostate cancer patient has the same chance of still being alive as a man without prostate cancer.

  • Ten years after diagnosis, the 10-year relative survival rate is 98 percent. This means that the average prostate cancer patient is only 2 percent less likely to survive than a man without prostate cancer.

  • Fifteen years after diagnosis, the 15-year relative survival rate is 95 percent. This means that the average prostate cancer patient is 5 percent less likely to survive than a man without prostate cancer.


What is Stage 1 Prostate Cancer?

Stage I prostate cancer, also known as early-stage or localized prostate cancer, indicates that the cancer is confined to the prostate gland and has not spread to nearby tissues or distant organs. At this stage, the cancer is typically small and may not cause noticeable symptoms, making early detection through screenings like the PSA crucial for effective treatment and improved outcomes. In stage 1 prostate cancer, symptoms are often minimal or absent. However, some men may experience mild symptoms such as frequent urination, weak urine flow, or difficulty starting and stopping urination.

What is Stage 2 Prostate Cancer?

Stage II prostate cancer indicates that the cancer has grown beyond the confines of the prostate gland, but is still localized within the prostate, and has not spread to distant sites. At this stage, the cancer may be larger in size and may have more noticeable symptoms, such as difficulties with urination or erectile dysfunction.

What is Stage 3 Prostate Cancer?

Stage III prostate cancer indicates that the cancer has spread beyond the prostate and may involve nearby tissues or organs, such as the seminal vesicles or the bladder. At this stage, the cancer may cause more pronounced symptoms and requires a more comprehensive treatment approach, such as surgery, radiation therapy, hormone therapy, or a combination of these modalities.

What is Stage 4 Prostate Cancer?

Stage IV prostate cancer, also known as advanced or metastatic prostate cancer, signifies that the cancer has spread to distant sites in the body, such as the bones, lymph nodes, or other organs. At this stage, the cancer is no longer confined to the prostate and may require systemic treatments such as hormone therapy, chemotherapy, targeted therapy, or immunotherapy to manage the disease.

What is Stage 5 Prostate Cancer?

Prostate Cancer is diagnosed according to a four stage system (I-IV) or a three stage system (TNM). There is no stage five for prostate cancer staging, although sometimes oncologist will use a Stage 0 in some forms of cancer. A Gleason Score uses a 2-10 point scale assigned to prostate biopsies to establish how fast a cancer is growing. This scale determines the speed of cancer growth, but it does not tell how far the cancer has spread throughout the body like the stages I-IV system or the TNM system.


Understanding the stages of prostate cancer, and their associated survival rates, is crucial for individuals and their loved ones navigating this complex disease. Each stage carries unique implications for prognosis and treatment options. Be sure to read our Prostate Cancer Treatment guide,

By staying informed, individuals can actively participate in their healthcare decisions and work closely with their healthcare team to determine the most appropriate course of action. Regular screenings, including prostate exams and PSA tests, are essential for early detection and intervention—particularly for those at higher risk.

It’s important to note that survival rates can vary depending on various factors, such as the stage at diagnosis, age, overall health, and response to treatment. Therefore, it’s crucial to consult with healthcare professionals who can provide personalized information and guidance based on individual circumstances.

As you continue your journey, remember that knowledge is power. Stay proactive by seeking reputable sources of information, engaging in discussions with healthcare providers, and connecting with support networks. Remember, you are not alone in this fight against prostate cancer.

Take charge of your health today. Schedule regular check-ups, be aware of potential symptoms, and encourage your loved ones to do the same. By spreading awareness and knowledge, together, we can make a difference.

If you have any questions or need further information about prostate cancer stages and survival rates, reach out to us or consult with your healthcare provider. Empower yourself with knowledge and be an advocate for your own health. Together, let’s strive for a future where prostate cancer can be detected early, treated effectively, and survivorship thrives.

Don’t wait. Take action now. Your health matters.

Learn more about prostate cancer staging near me today.