TNM Classification

What stage is my prostate cancer?

The TNM classification describes the size and extent of the tumor as well as the spread of cancer cells in other organs. The classification into different stages is based on three criteria:

• Size and spread of the tumour in the prostate (T)
• Absence or presence of local or adjacent (regional) lymph node metastases (N)
• Presence of distant metastases (M)

Classification and Importance of TNM Classification in Prostate Cancer

Primary tumor

 T1     The tumor is neither palpable nor detectable by imaging methods (ultrasound, MRT, CT).

            T1a   Chance finding, less than 5 % of tissue contains cancer cells
            T1b   Random finding, more than 5 % of tissue contains cancer cells
            T1c   After an elevated PSA level, cancer cells were found in the biopsy

T2     The tumor is palpable or visible in ultrasound, but is still limited to the prostate gland.

           T2a   The tumor is limited to less than half the size of a prostate lobe.
           T2b   The tumor occupies more than half of a prostate lobe
           T2c   The tumor has affected both prostate lobes.

T3   The tumour has already broken through the prostate capsule and has grown into the connective tissue around the prostate or seminal vesicle.

            T3     The tumor has spread outside the prostate gland. 
            T3b  The Tumor has infiltrated seminal vesicle

T4      The tumor has spread further into neighbouring organs such as the bladder or intestine.

Lymph nodes

N0     The neighbouring lymph nodes are tumor-free.

N1     The neighbouring lymph nodes are

Metastases

M0     There are no metastases present

M1 Metastases are present

An example: T1 N0 M0 would mean that it is a small tumor without lymph node infestation and without metastases.