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Stages of Prostate Cancer: What You Need to Know in NJ, CT, MD, and the Washington, D.C., Area

It is estimated that one in every eight men will be diagnosed with prostate cancer at some point in their lives. Cancer of the prostate continues to be a concern to all people assigned male sex at birth, especially older people.

Once doctors have determined that a patient has prostate cancer, their focus shifts to determining the cancer’s nature and status, including whether it has spread. This process is called staging. Knowing the stage of a patient’s prostate cancer enables medical oncologists to initiate the most appropriate care plan and to provide important information to patients and their families.

With a team of board-certified oncologists and hematologists, Regional Cancer Care Associates (RCCA) specializes in treating many types of cancer, including prostate cancer. With locations in New Jersey, Connecticut, Maryland, and the Washington, D.C., area, RCCA provides patients with personalized care plans and educates them on their conditions. Discover more about the different stages of prostate cancer and how each stage affects a patient’s treatment plan.

What Is Prostate Cancer?

Prostate cancer develops when abnormal cells form and begin growing rapidly in the prostate gland. Located below the bladder and in front of the rectum, the prostate is a walnut-sized gland that is part of the male reproductive system. The main function of the prostate is to produce seminal fluid, which nourishes and transports sperm.

Physician meeting with patient to review prostate cancer stages

Stages of Prostate Cancer

After thoroughly assessing a patient’s prostate cancer, medical oncologists will assign the cancer a stage. The staging system is standard for all cancer types and is used to characterize how far cancer has spread. The most widely used staging system for prostate cancer is the American Joint Committee on Cancer (AJCC) TNM system. Using this system, oncologists consider the following:

  • The extent of the primary tumor
  • Whether cancer has spread to nearby lymph nodes
  • Whether cancer has spread (metastasized) to other areas of the body
  • The prostate-specific antigen (PSA) level from blood testing
  • The grade group, which is a measure of how likely the cancer is to grow and spread quickly

The main stages of prostate cancer range from I to IV. With this staging system, the higher the number, the more the cancer has spread.

Stage I Prostate Cancer

Prostate cancer in its earliest stage is classified as Stage I. At this point, the tumor is only in the prostate gland and is very small and slow-growing. Patients with Stage I prostate cancer often do not notice any symptoms or health problems.

Additionally, the tumor may be difficult to detect during Stage I prostate cancer. A doctor may not be able to feel the tumor during a digital rectal exam or see it on an ultrasound scan. Detecting prostate cancer at this stage gives patients the greatest chance of cure and survival.

  • Grade group: 1
  • PSA level: Less than 10 ng/mL or between 10 and 20 ng/mL
  • 5-year relative survival rate: Nearly 100%

Treatment options for Stage I prostate cancer can include active surveillance, radiation therapy, and radical prostatectomy.

Stage II Prostate Cancer

If undetected, early prostate cancer can progress to Stage II. Tumors in this stage are much larger than tumors in Stage I. Because of this, physicians are much more likely to recommend a more proactive treatment plan.

With Stage II prostate cancer, there is a greater chance of cancer coming back after treatment (recurrence). To guard against recurrence, continued surveillance and regular checkups are necessary.

  • Grade group: 1 (IIA), 2 (IIB), 3 (IIC)
  • PSA level: At least 10 ng/mL but less than 20 ng/mL
  • 5-year relative survival rate: Nearly 100%

Treatment approaches for Stage II prostate cancer generally are more aggressive than those used in Stage I. They can include active surveillance, radiation therapy, radical prostatectomy, and clinical trials, among others.

Stage III Prostate Cancer

In Stage III prostate cancer, the cancer has started to spread and is no longer affecting only the prostate gland. At this point, the cancer also may be in nearby tissues, lymph nodes, or even distant organs. To help patients and their doctors gain control over the cancer, more aggressive treatment is typically required. In Stage III, the risk of recurrence also increases.

  • Grade group: 1 to 4 (IIIA, IIIB), 5 (IIIC)
  • PSA level: At least 20 ng/mL (IIIA), or any PSA level (IIIB, IIIC)
  • 5-year relative survival rate: Nearly 100%

When treating Stage III prostate cancer, care plans can include several treatment options, including radiation therapy plus hormone therapy, radical prostatectomy, and clinical trials.

Stage IV Prostate Cancer

Stage IV prostate cancer is the most progressed form of the disease. When a patient is diagnosed with Stage IV prostate cancer, it means the cancer has already spread to nearby areas, particularly the bladder or rectum. It also may have spread to the lymph nodes, bones, lungs, liver, and other distant organs.

Due to the advanced nature of the cancer and how much it has spread, the 5-year survival rate decreases drastically. At this point, the goal of treatment is to control the cancer, extend survival, and make the patient as comfortable as possible.

  • Grade group: Any grade group
  • PSA level: Any PSA
  • 5-year relative survival rate: Approximately 30% (distant stage IVB cancer)

Treatment options for Stage IV prostate cancer can include active surveillance, hormone therapy, chemotherapy, radiation, radical prostatectomy, surgery to relieve symptoms, and clinical trials.

Treatment Options for Prostate Cancer

Treatment options for patients with prostate cancer include:

Active Surveillance

In some cases, physicians and patients will opt for careful, regular monitoring of the cancer rather than a medical or surgical intervention. This approach, known as active surveillance, often is recommended if the cancer is small, is not causing any symptoms, is still only in the prostate, and is expected to grow slowly. Active surveillance usually involves doctor visits every six months, where healthcare professionals will perform various exams to remain up-to-date on the condition of cancer.


Radical prostatectomy is the surgical approach used most often in the treatment of prostate cancer. This operation entails the surgeon removing the entire prostate gland, plus some of the tissue around it, including the seminal vesicles. Surgery is a common option for treating prostate cancer if the disease is believed not to have spread outside the prostate gland.

Radiation Therapy

Radiation therapy uses high-energy rays or radiation-emitting pellets or drugs to destroy cancer cells or slow their growth. There are several types of radiation therapies, such as:

  • External radiation
  • Internal radiation (brachytherapy)
  • Radioactive drugs

Hormone Therapy

Prostate cancer is fueled, at least in its early stages, by androgens, the male sex hormones.  The goal of hormone therapy is to reduce a patient’s hormone levels to stop them from driving prostate cancer cell growth.

Hormone therapy for prostate cancer works in two ways. It either suppresses the body’s ability to make the hormones that fuel development of cancer or it interferes with the activity of those hormones. In many cases, hormone therapy is used in conjunction with other treatments.


Chemotherapy is one of the most common approaches to treating all types of cancers, including advanced prostate cancer. With this treatment, anti-cancer drugs are injected into a vein or given by mouth. Traveling through the bloodstream, these drugs are designed to reach cancer cells and attack and kill them.


Immunotherapy involves the use of medicines to stimulate a person’s own immune system to recognize and more effectively destroy cancer cells. Because the immune system is made up of many different parts, there are several different types of immunotherapy treatments, such as:

Targeted therapy

Targeted therapies act against specific cellular mutations that play a role in a cancer’s development and spread while not affecting healthy tissues.

Trust the Compassionate Prostate Cancer Care Team at RCCA

The stage of cancer indicates how far along the disease is and how much it has spread. Knowing the stage of a patient’s prostate cancer is vital because it determines the appropriate course of action for treatment.

The board-certified medical oncologists and hematologists of Regional Cancer Care Associates specialize in treating blood disorders and a wide range of cancer, including prostate cancer. Serving individuals in New Jersey, Connecticut, Maryland, and the Washington, D.C., area, the RCCA medical team ensures that all patients receive the best possible care. Contact Regional Cancer Care Associates today for more information regarding prostate cancer treatment options or schedule an appointment at one of RCCA’s 20+ locations for treatment.

Learn More about Prostate Cancer Care at RCCA

If you’ve been diagnosed with prostate cancer or are concerned about potential symptoms, contact RCCA today. Our team of cancer care specialists will assess the stage of your cancer using the latest diagnostic methods and work with you to design a fully individualized care plan that includes advanced treatment options, the potential for clinical trials, and support that addresses physical and emotional well-being. To speak with a representative right away, please call 844-346-7222.


Regional Cancer Care Associates is one of fewer than 200 medical practices in the country selected to participate in the Oncology Care Model (OCM); a recent Medicare initiative aimed at improving care coordination and access to and quality of care for Medicare beneficiaries undergoing chemotherapy treatment.