SolveYourProblem Article Series: Cancer
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What is Stage B, Stage C & Stage D Prostate Cancer?

Stages A, B, and certain stage C disease include cancers that have not spread; they have not spawned new tumor colonies in other tissues away from the prostate gland. Some stage C and all stage D disease consists of tumors that have already spread beyond the prostate capsule either by direct extension (growth into surrounding tissue) or metastases.

Stage B

Stage B cancers are palpable - meaning large enough to be felt as a nodule or hardening in the peripheral zone of the prostate gland during a rectal examination, which is generally how they are diagnosed. They usually do not cause any symptoms or discomfort, although some men may have urinary symptoms that were believed to be related to BPH.

B1 designates a small nodule found only on one lobe, while large or multiple nodules are usually staged as B2 disease. All stage B tumors are those still localized to the gland, with no metastases or direct extension to surrounding tissue. However, at the time of surgery, they are often found to be more extensive - pointing to a limitation in our ability to stage cancer "clinically" before treatment is undertaken.

Stage C

Stage C tumors have spread through most or all of the prostate gland, making it rock hard, and have pushed past the borders of the prostate into surrounding structures. C1 is the category often used for disease that has spread outside the prostate capsule but not to the seminal vesicles, while C2 and C3 describe cancer that is believed to have spread to involve the seminal vesicles. Patients who have stage C cancers are often diagnosed after urinary symptoms cause them to seek medical help.

If the cancer has spread into the seminal vesicles adjacent to the prostate, the patient is still classified as having stage C disease, but often he will soon develop evidence of spread to distant organs. For this reason, some patients with stage C2 or C3 cancer will be treated as though they in fact have metastatic or stage D disease.

Stage D

Stage D is cancer that has metastasized to the lymph nodes or bone, or possibly other tissues as well. D1 is the substage used to describe patients who have cancerous cells detected in their lymph nodes, while D2 describes those who have actual metastases in the bone or sometimes other tissues. Two other subcategories are sometimes mentioned. Stage D3 is sometimes used to describe metastatic prostate cancer that has become resistant (refractory) to hormonal therapy.

You must understand that "D" does not stand for death. Men with stage D1 disease many times live out normal lives if they receive appropriate and timely treatment. Stage D2 disease can also be controlled for long periods of time, sometimes a number of years, before the cancer becomes resistant to our best available treatments.

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