Staging systems

After determining the extent of the cancer, doctors use one of two methods to describe the cancer's clinical stage. These are the Whitmore-Jewett and TNM (tumor, node, metastasis) systems.

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The Whitmore-Jewett system uses stages A, B, C, and D—with A indicating the earliest cancer and D the most advanced—to describe the extent of the tumor. The stage is further subdivided with numbers, for example, stage A1 or A2, for a more specific indication of the percentage of cancerous tissue.

The TNM system assigns a T number (T1 to T4) to a tumor according to its extent on a digital rectal examination; an N number (N0 to N3) indicating lymph node involvement; and an M number (M0 to M1) to indicate the presence of distant metastases. These stages are further subdivided into a, b, and c to describe how the cancer was diagnosed and the extent of cancerous tissue. The most commonly diagnosed stage of cancer today is T1c, indicating that the cancer was not found during a digital rectal exam but was identified by needle biopsy after finding an elevated PSA.