Prostate Cancer: Understanding the TNM Staging System

Staying involved in treatment decisions and understanding prostate cancer language is important for victims and their families.  When my husband was diagnosed with prostate cancer a year ago, I immediately went to the Internet to read all I could about it.  I found a wealth of valuable information, and had to wade through some heavy reading to sort it all out.

The staging system known as TNM describes the clinical stage of the cancer and how far it has spread.  TNM stands for how the tumor (T) feels to the physician; the second letter stands for whether or not cancer has spread to nearby lymph nodes (N); metastasis (M) indicates whether or not cancer has spread to other parts of the body.

The T number varies from T1 to T4.  This number is a judgment call on the part of the physician doing the rectal exam and the pathologist reading the results of a biopsy.  Lower numbers indicate contained and limited cancer cells, while higher numbers (3 and 4) indicate the tumor’s growth beyond the prostate gland and into adjacent structures such as seminal vesicles, bladder, rectum and pelvis.

The N numbers are much more simple.  A NO indicates no cancer in the lymph nodes.  N1 reveals cancer cells in lymph nodes in the pelvis.

The M numbers describe if and where cancer has metastasized (spread).  MO means there is no metastasis outside the pelvic region.  M1,1a,1b,1c indicate the spread of cancer as follows:

MO: No distant metastasis 
M1: Distant metastasis 
M1a: Cancer spread, distant lymph nodes 
M1b: Cancer spread, bones 
M1c: Cancer spread, other organs

Understanding the TNM numbers helps keep the patient and his wife and family involved in determining what treatment is chosen.  The American Cancer Society web site provides a questionnaire process visitors may use to sort out treatment options based on the TNM grading scale

Remember, knowledge is power!  The more you know about prostate cancer, the more you will be able to participate in treating it and getting well so you can move on to the rest of your life!