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Prostate cancer is one of the most common malignant tumors among men older than the age of 65; it also is one of the deadliest if it is not detected and treated in its early stages. Doctors use staging systems to track prostate cancer progression and to choose the most appropriate treatment for a patient's particular stage. Several different staging systems are in use worldwide, but one of the most common and most reliable is the Tumor, Nodes, and Metastasis (TNM) system. A doctor can get information from physical exams and laboratory tests to determine the size of a prostate tumor, any involvement of lymph nodes, and evidence of cancer metastasis, or spread, to other parts of the body. Effectively tracking prostate cancer progression not only helps with treatment efforts, but it also gives a patient a realistic prognosis for his disease.
Each component of the TNM system for prostate cancer progression can be broken down into smaller, descriptive stages. A very small tumor that is barely detectable by physical evaluations, needle biopsy, and lab tests is classified as T1. A T2 tumor is palpable, but confined entirely within the prostate gland. T3 and T4 indicate that a cancerous mass has grown large enough to impede on surrounding structures in the body, such as the seminal vesicles, rectum, and bladder.
Prostate cancer progression from the initial tumor usually begins in the lymph nodes in the pelvic region. A rating of N0 means that the nodes are susceptible, but not yet affected. N1 indicates involvement of pelvic lymph nodes, which is detectable through blood tests and biopsy results.
Metastasis represents the final and most dangerous stages of prostate cancer progression. A rating of M1a indicates that cancer can be detected in lymph nodes far away from the pelvic region, such as those underneath the arms and in the neck. M1b means that doctors have detected cancer in bone tissue, and M1c describes spread to other tissues and organs.
When prostate cancer is discovered before N and M stages, the primary tumor can usually be removed via surgery. A surgeon may be able to isolate and excise a small tumor or remove the entire gland if it is wholly affected. Radiation treatments are often effective against tumors that cannot be removed, and can also help to slow or stop progression to lymph nodes and other organs. If cancer has already metastasized, a patient may need to undergo radiation, chemotherapy, and take hormone replacement medications. Ongoing monitoring, careful treatment, and frequent analysis of prostate cancer progression helps many patients add several years or even decades to their prognoses.