Once prostate cancer has been diagnosed, the oncologist will categorise it into stages. The staging system for prostate cancer standardises the extent to which the cancer has spread. There are various staging systems for prostate cancer and the type most used is the TNM system.

The TNM System

The TNM system provides a description of the primary tumor, known as the ?T stage?. It also indicates whether or not the cancer has spread to the nearby lymph nodes, known as the ?N stage,? along with the presence or absence of distant Metastasis, known as the ?M Stage.? Metastasis is the medical term which defines whether or not the cancer cells have spread from the prostate gland to another part of the body.

The prostate's tumor (T-Stage) is described via four categories which rang from T1 to T4. The following provides a description of each of the four stages:

T1 ? refers to microscopic cancer which is unilateral and non palpable. This stage means that the doctor is unable to feel the tumor or visualise it using transrectal imaging or other forms. The disease may have been diagnosed during treatment for BPH or via a needle biopsy taken due to high levels of PSA.

T2 ? the tumor can be felt via a digital rectal examination. The doctor believes the tumor is confined to the prostate gland.

T3 ? the Cancer has spread to the tissues immediately near the prostate gland.

T4 ? Cancer has spread to other areas of the body

There are a number if tests which the doctor will perform to enable him to stage the prostate cancer:

Digital Rectal Examination

The doctor will be able to determine whether the cancer is T1, T2, T3 or beyond.

Prostatic Acid Phosphatase (PAP) Blood Test

This will help the doctor determine whether the cancer is confined to the prostate or has spread further.

Biopsy

When prostate cancer has been detected, a biopsy (small samples of tissue taken from the prostate) may be taken. A pathologist will evaluate the tissue before giving a combined Gleason grade Score (CGS).

The CGS rages from 2 10 and the higher the number, the more aggressive the cancer is. This grading is very important when considering the aggressiveness of the cancer

The grade will range from 2 to 10. The higher the number, the more aggressive is the cancer. The Gleason grade is a major factor in deciding the best treatment for the cancer.

Annual prostate specific antigen (PSA) bloods tests are advised for men over the age of 50 years (or 45 years for those men who have a higher risk of developing prostate cancer) along with a digital rectal examination.

It is also important that you are aware of all the symptoms that you may have in between the annual tests. Although having any of these symptoms does not necessarily mean that you have prostate cancer, it is advisable to seek medical advice to ensure that immediate treatment is received. In short, symptoms include:

* the inability to urinate

* increase need to urinate, particularly at night time

* difficulties with stopping (holding back) and starting urination.