The prostate cancer stages tell the healthcare team about the size of the cancer and how quickly it's growing. The stage helps the care team make a treatment plan.
Staging information
The healthcare team uses this information to decide on the prostate cancer stage:
- How much of the prostate has cancer. If the cancer only involves part of the prostate, the stage is low. If the cancer takes up more of the prostate, the stage may be higher.
- Whether the cancer grows beyond the prostate. If the cancer grows through the wall of the prostate, it's considered stage 3. The cancer may extend through the prostate and into the rectum, bladder or other nearby areas.
- Whether the cancer spreads to the lymph nodes. Prostate cancer can spread through the lymphatic system to nearby lymph nodes. If this happens, it's considered stage 4.
- Whether the cancer spreads to other parts of the body. Prostate cancer can spread to the bones, liver, lungs and other parts of the body. If this happens, it's considered stage 4.
- The level of PSA in the blood. An increased PSA level usually makes the stage higher. For staging, a low PSA level is less than 10 nanograms per milliliter (ng/mL). An intermediate level is between 10 and 20 ng/mL. A high PSA level is greater than 20 ng/mL.
- The grade group. Grade group is based on the Gleason score. The groups go from 1 to 5, with a low number meaning the cancer is likely to grow slowly. A higher number means the cancer is more aggressive and is likely to grow quickly. A higher grade group number makes the stage higher.
Prostate cancer stages use numbers and letters to describe the extent of the cancer and how quickly it's growing. The numbers go from 1 to 4. A smaller number often means a smaller cancer that is growing more slowly. Cancers that are bigger or more aggressive get higher numbers. Some stages also have letters, such as 2A, 2B and 2C. The letters divide up the numbered stages into smaller categories.
Stage 1
A stage 1 prostate cancer means the cancer is small and only in the prostate. The cancer affects less than one half of one side of the prostate gland. The PSA level is low and the grade group is 1.
Stage 1 treatment usually involves active surveillance because the cancer is small and growing slowly. Still, some people might choose to have treatment if they are younger and willing to accept some side effects in order to cure the cancer.
Stage 2
A stage 2 prostate cancer means the cancer is only in the prostate, but it may involve more of the gland than in stage 1. Stage 2 includes low and intermediate PSA levels and grade groups 1 to 4.
- Stage 2A. Stage 2A prostate cancers are grade group 1. At this stage, the cancer may be a small cancer that only affects one side of the prostate but has an intermediate PSA level. Or it can be a larger cancer that affects both sides of the prostate but has a low PSA level.
- Stage 2B. Stage 2B prostate cancers are grade group 2 and the PSA level is low or intermediate. This stage includes any size cancer, as long as the cancer hasn't grown beyond the prostate.
- Stage 2C. Stage 2C prostate cancers are grade group 3 or 4 and the PSA level is low or intermediate. This stage includes any size cancer, as long as the cancer hasn't grown beyond the prostate.
Stage 2 treatment can involve active surveillance, especially if the PSA level and the grade group are low. If you choose treatment, the options typically include surgery to remove the prostate, called prostatectomy, and radiation therapy. Radiation therapy options include external beam radiation therapy and brachytherapy.
Stage 3
A stage 3 prostate cancer means the cancer is more advanced than in stage 2. The cancer may have grown through the prostate. This stage includes cancers that happen with high PSA levels and high grade group numbers.
- Stage 3A. With stage 3A prostate cancers, the PSA level is high. This stage includes grade groups 1 to 4. The cancer can be any size, as long as it hasn't grown beyond the prostate.
- Stage 3B. Stage 3B prostate cancers have grown beyond the prostate. The cancer might extend to the seminal vesicles, bladder, rectum or other nearby organs. This stage includes all PSA levels and grade groups 1 to 4.
- Stage 3C. Stage 3C prostate cancers are grade group 5. This stage includes any size prostate cancer and all PSA levels. The cancer may have grown beyond the prostate, but it hasn't spread to the lymph nodes or to other parts of the body.
Stage 3 treatment usually involves treating the cancer unless you have other health conditions that are more urgent. Stage 3 cancers have a high risk of spreading because the cancer has grown beyond the prostate or shows signs of growing quickly. Treatment options may include surgery or a combination of radiation and hormone therapy.
Stage 4
Stage 4 prostate cancer means the cancer has spread away from the prostate. It's also called metastatic prostate cancer. Stage 4 cancers can be any PSA level and any grade group number.
- Stage 4A. Stage 4A prostate cancers have spread to nearby lymph nodes.
- Stage 4B. Stage 4B prostate cancers have spread to other parts of the body, such as the bones, liver and lungs.
Stage 4 treatment usually starts with hormone therapy. If the cancer has spread to the lymph nodes, surgery and radiation therapy to the prostate may still be options. If the cancer spreads to other parts of the body, treatment usually involves medicines that can kill prostate cells anywhere in the body.
Common questions about stages
Questions people with prostate cancer ask about stages include:
- What does early stage mean? Early-stage prostate cancer means the cancer is only inside the prostate. This is usually a stage 1 or stage 2 cancer.
- Is there a stage 5 prostate cancer? There is no stage 5 prostate cancer, as the stages go from 1 to 4. However, there is a grade group 5. Prostate cancer grade groups go from 1 to 5. In prostate cancer, grade group 5 means the cancer cells look very different from healthy cells and are likely to grow quickly. All grade group 5 prostate cancers are stage 3B, no matter their size.
- How do symptoms vary by prostate cancer stage? Stage 1 and stage 2 prostate cancers aren't likely to cause symptoms. Symptoms are more likely to happen with a larger cancer. If the cancer spreads, it most often goes to the bones, which may cause bone pain and other symptoms.
- Is stage 2 prostate cancer bad? Stage 2 prostate cancer has a good prognosis. Some people may not need treatment for this stage of cancer, but others may choose to have treatment.
- How dangerous is stage 3 prostate cancer? Stage 3 prostate cancer has grown beyond the prostate or has features that make it more dangerous, such as a high PSA level or a high grade group. Stage 3 prostate cancer has a good prognosis because the cancer cells haven't spread away from the prostate. But it also has a higher risk of spreading to the lymph nodes and other parts of the body.
- What is the best treatment for my prostate cancer stage? There are many treatment options and there often isn't one best treatment for each stage. Stage is one thing your healthcare team thinks about when creating a treatment plan. Many more things may factor into the decision, such as your overall health, other serious health conditions you may have, your symptoms, your goals for treatment and the side effects you're willing to accept.
Feb. 20, 2026