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How Each Prostate Cancer Stage Differs From The Other
Prostate cancer occurs when cells in the prostate, which is the organ located below your bladder and in front of your rectum, begin to multiply abnormally, leading to a tumour. When this happens, a person may not experience any symptoms or may show some signs, depending on the stage of progression.
In general, prostate cancer, like any other cancer, has four stages, says Dr Bhuvanesh N Aradhya, Consultant - Urology and Kidney Transplant Surgeon, HCG Suchirayu Hospital, Hubli. While the first stage is the earliest, stage four indicates that the cancer has spread to different organs in the body, the doctor explains. In this article, we delve deeper into the different stages of prostate cancer and discuss the importance of regular screening and early detection.
Also Read: Frequent Urination To Blood In Urine, Symptoms That Should Urge You To Get Tested For Prostate Cancer
What Are The Different Stages Of Prostate Cancer?Breaking down prostate cancer stages into four categories, Dr Aradhya shares:
Stage 1: In this stage, the cancer is confined to the prostate gland. In this stage, the tumour cannot be felt by clinical examination and can most likely be seen in imaging studies (CT scan or MRI). According to the doctor, in this stage, the cancer involves less than 5% of the gland, and symptoms are usually similar to those of prostate enlargement, like frequency, urgency, poor stream, and incomplete emptying of the bladder. Most cardinal symptoms would be blood in the urine, he adds.
Stage 2: In this stage, the tumour is confined to the prostate gland but can be felt during physical examination. The symptoms in this stage are also similar to those in the first stage, where blood in the urine is a telltale sign. The Prostate-Specific Antigen (PSA) levels may be slightly higher than the normal range of 4 mg/dl.
Stage 3: In this stage, the tumour tends to grow outside the prostate and may have spread to tissues next to the prostate gland, which include the rectum, bladder, and urethral sphincter. Most of the patients in these stages require treatment. In fact, in stages 1 and 2, the tumours can be removed completely, setting one free of the disease. In stage 3, patients may require multimodality treatments like hormonal treatment followed by surgery tailored according to the patient.
Stage 4: In this stage, the cancer has spread to different organs of the body, like the liver, bones, lungs, and lymph nodes. This stage can only be controlled, where patients may receive only treatments aimed at controlling the disease rather than a cure. General weakness, loss of weight, and easy fatigability are common symptoms at this stage.
Role Of Early DetectionDr Ardhya says, "Early detection of prostate cancer is extremely important, as the cancer can be removed completely in the early stages."
"Complete removal of the tumour will lead to normal life and cancer-free survival," he emphasises.
According to Cancer Research UK, almost everyone will survive their cancer for five years or more after they are diagnosed in the early stages, or stage 1 or 2.
Around 95 out of every 100 men will survive their cancer for five years or more after diagnosis in stage 3, whereas only around 50% will survive their cancer after they are diagnosed in stage 4, the charity suggests.
Understanding The Risk Factors And Reducing The ChanceSome of the common risk factors for prostate cancer include:
According to Dr Aradhya, regular screening for prostate cancer includes yearly PSA levels in the blood and a clinical examination by a urologist.
"If there is a strong history of prostate cancer in the family (more than one male in the family suffered from this cancer), the screening should be started at 40 years of age," he stresses, adding that for other men, the screening can be started after 50 years of age.
The doctor further warns against smoking and the consumption of tobacco and encourages following a healthy lifestyle to reduce the risk of prostate cancer.
He concludes, "Regular screening can make a huge difference in the outcomes of this deadly disease.
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Alonzo Mourning Reveals Prostate Cancer Diagnosis And Surgery
Alonzo Mourning (R), pictured here with Daymon John, a guest and Mariona Bosca on February 4, 2024, ... [+] has been going through a prostate cancer journey. (Photo by Romain Maurice/Getty Images for Haute Living)
Getty Images for Haute LivingCount Hall of Fame center Alonzo Mourning as the latest high-profile individual to reveal that he was diagnosed with prostate cancer. The former Charlotte Hornet and Miami Heat star had Stage 3 prostate cancer with a Gleason score of 8, representing a high-grade aggressive form of cancer. He underwent surgery to remove his prostate in mid-March.
Over the past few months, it seems like every month at least one public figure has had a public revelation about a prostate cancer diagnosis. On April 12, former National Institutes of Health Director Francis Collins, M.D., Ph.D., published an article in The Washington Post entitled, "Why I'm going public with my prostate cancer diagnosis." Then the following month, on May 23, there was the article written by Gillian Telling for People magazine that bore the title, "Seinfeld's Michael Richards Reveals Prostate Cancer Battle: 'I Would Have Been Dead in 8 Months' Without Surgery."
The 54-year-old Mourning told Adrian Wojnarowski, reporting for ESPN, that his prostate specific antigen (PSA) screening blood test scores were "creeping up" in late 2022. This prompted an MRI of his prostate, which showed some suspicious findings, which, in turn, led to a biopsy of his prostate. The biopsy offered the definitive unfortunate diagnosis that Mourning had prostate cancer.
The tissue from the biopsy also allowed Mourning's pathologist to determine the grade of his cancer based on what the cancer cells looked like under a microscope. This is important because it shows how aggressive the cancer may be and helps determine prognosis and treatment. Pathologists assign the specimen a Gleason score, named after Donald Gleason, M.D., who came up with the scoring system in the 1960s. Each cell can take on a grade of 1 to 5, with Grade 1 cells representing normal looking prostate tissue. By contrast, cells that have a Grade 5 assignment are high-grade cancer cells.
The Gleason score then comes from adding the grade of the most predominant cellular pattern to the grade of the second most predominant pattern. So, if the most predominant pattern was a Grade 4 and the second most predominant pattern was a Grade 3, then your Gleason score would be 7. That means that a Gleason score could range from 2 to 10, with any cancerous sample ranging from a 6 to a 10.
So, the lowest-grade cancer you could have would have a Gleason score of 6. A Gleason score of 7 means an intermediate grade cancer, and anything 8 or greater would be high grade. Since the grade can represent the aggressiveness of the cancer cells, the presence of any Grade 5 cells can significantly increase the risk of prostate cancer recurrence after treatment.
The good news is that many prostate cancers are relatively slow growing. So the hope is that you can catch it before it spreads to other parts of the body. Soon after Mourning was diagnosed with prostate cancer, his urologic oncologist ordered a PET scan to look for where the cancer may have spread.
"My partner, Mariona, is waiting for me outside the PET scan, and we are nervous as hell," Wojnarowski quoted Mourning as saying. "I'm sitting in the machine with my arms over my head and my mind racing — waiting for the technician to read the scan." That can be like waiting for the final score of a really, really important game without being able to do anything about it.
"We ended up in a cold waiting room waiting for the tech to come in and finally he looks at us and says he's got good news: The cancer is still in the [prostate] capsule and hasn't spread," Mourning continued. That meant that his cancer was still at Stage 3 rather than Stage 4, which is when the cancer has spread beyond the prostate area to lymph nodes or beyond. While Stage 4 cancers can still be treated and controlled, you can no longer remove all of the cancer via surgery, meaning that survival rates could be significantly lower.
Alonzo Mourning (R), playing for the Miami Heat, guards Orlando Magic center Shaquille O'Neal (L) ... [+] during an NBA game at the Orlando Arena. (Photo: TONY RANZE/AFP via Getty Images)
AFP via Getty ImagesAs with any cancer, the sooner you detect and treat prostate cancer, the higher the survival rate. The challenge is that prostate cancer typically will not cause symptoms until it has reached its later stages. That's why PSA screening is so important. Mourning, who was a seven-time All-Star, an NBA champion and an Olympic gold medalist, was a picture of health before his diagnosis. He had also successfully undergone a kidney transplant, so he was already plugged into the healthcare system. As a result, the diagnosis came as quite a shock.
"What scares me about this disease is that there are so many men walking around feeling great and have that cancer in them and they don't know it," Wojnarowski quoted Mourning as saying. "The only way to find out is to get their blood tested and get their PSA checked. There are 3.3 million men living in the U.S. With prostate cancer, and many don't even know it. I was one of those guys."
With Mourning, Collins and Richards openly talking about their prostate cancer journeys, the hope is that more men will more freely talk about what's the second most common cancer diagnosis among men. Many men can be a bit squeamish about discussing such issues, since it may not seem macho to worry about disease. Moreover, the prostate is close to a lot of oh-no-we're-not-going-to-talk-about-it structures. Prostate cancer surgery can, in turn, affect urinary and sexual function, topics that can leave men trying to shift the conversation to something like, "Hey did you catch the basketball game last night?"
But a manly man is a term that can apply to Mourning. Anyone who saw Mourning play during his illustrious 15-year NBA career will know what a force he was. And by bringing more attention to this disease he is proving that he is still quite a force.
Hall Of Fame NBA Center Suffering From Stage 3 Prostate Cancer
Hall of Fame former NBA center Alonzo Mourning is dealing with Stage 3 prostate cancer, reveals Adrian Wojnarowski of ESPN. He recently had surgery to remove the prostate entirely.
The 6-foot-10 center/power forward, a seven-time All-Star and 2006 champion with the Miami Heat revealed that he hopes to be an advocate and encourage men of a certain age to get checked. Mourning found out in 2022, at the age of 52.
"What scares me about this disease is that there are so many men walking around feeling great and have that cancer in them and they don't know it," Mourning told Wojnarowski. "The only way to find out is to get their blood tested and get their PSA checked. There are 3.3 million men living in the U.S. With prostate cancer, and many don't even know it. I was one of those guys."
Shaquille O'Neal #32 of the Miami Heat is helped off the court by teammates Antoine Walker #8 and Alonzo Mourning #33 after stepping on the foot of Ron Artest #15 of the Indiana Pacers November... Shaquille O'Neal #32 of the Miami Heat is helped off the court by teammates Antoine Walker #8 and Alonzo Mourning #33 after stepping on the foot of Ron Artest #15 of the Indiana Pacers November 3, 2005 at the American Airlines Arena in Miami, Florida. Mourning revealed he's struggling with prostate cancer. More Doug Benc/Getty ImagesMourning was part of a particularly starry big-man college draft class in 1992. He was selected with the No. 2 pick out of Georgetown by the Charlotte Hornets, sandwiched between eventual Miami Heat teammate Shaquille O'Neal, then selected by the Orlando Magic out of LSU with the No. 1 pick, and two-time NCAA championship-wining Dukie Christian Laettner, who was drafted by the Minnesota Timberwolves at No. 3.
"Life was good and amazing for me, but if I had ignored getting checked and let this go, the cancer would've spread through my body," Mourning revealed. "Unfortunately, as men, we don't like to go to the doctor, but this is the only way to find out what's going on in your body. Prostate and even colon cancer are silent killers and many men won't get those [diagnoses] until it's too late."
Mourning has dealt with his share of major health scares before. He was diagnosed with a severe kidney disease following his gold medal showing at the 2000 Summer Olympics. He eventually retired in 2003-04 while with the New Jersey Nets as a result of complications stemming from his kidney issues, but after a successful transplant, he un-retired ahead of the 2004-05 season.
"We live in a world where it's taboo among men to talk about health issues," Mourning noted. "If I didn't get routine checkups, I probably wouldn't be here to talk about this. I want men to be proactive with their health."
Across a 15-year career with the Hornets, Heat, and Nets, Mourning appeared in 838 regular season contests, averaging 17.1 points on 52.7 percent shooting from the floor, 8.5 rebounds, a whopping 2.8 blocks, and 1.1 assists. In addition to the aforementioned seven All-Star appearances, Mourning was also a two-time All-Defensive Team honoree and the two-time Defensive Player of the Year. He was a formidable post presence during his prime seasons with the Hornets and Heat, and even following his kidney disease diagnosis, he evolved into a formidable force on that side of the floor, even managing to finish eighth in Defensive Player of the Year voting as O'Neal backup on that 2005-06 title-winning Heat squad.
Newsweek is committed to challenging conventional wisdom and finding connections in the search for common ground.
Newsweek is committed to challenging conventional wisdom and finding connections in the search for common ground.
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