At Arkansas Urology, our mission is to provide advanced care, expert guidance, and compassionate support for patients diagnosed with prostate cancer. Understanding the stages of prostate cancer helps patients and their families make informed decisions about treatment and next steps. Most prostate cancers grow slowly, but timely evaluation matters. If you’ve recently been diagnosed or are seeking a second opinion, schedule a consultation with one of our specialists today.
Understanding Prostate Cancer and How It’s Diagnosed
Prostate cancer develops in the prostate gland—a small organ within the male genitourinary system that produces seminal fluid. When normal prostate cells (normal cells) mutate, they become cancer cells and can form a tumor. The earlier this is detected, the more treatment options are available for early prostate cancer or early stage disease.
Doctors at Arkansas Urology use advanced diagnostic technology to accurately diagnose prostate cancer and determine its stage. Common diagnostic tests include:
- Prostate-specific antigen (PSA) blood test or prostate specific antigen test to detect elevated PSA levels.
- Digital rectal exam (DRE) to check for irregularities in the prostate.
- Prostate biopsy and needle biopsy to confirm the presence of prostate cancer cells and analyze prostate tissue.
- Magnetic resonance imaging (MRI) and transrectal ultrasound—key imaging tests used to find prostate cancer and assess nearby structures.
- Molecular testing
After prostate cancer diagnosis, our urologists evaluate the Gleason score, grade group, and prostate cancer risk stratification to understand how aggressive the tumor cells appear under the microscope. These findings, along with imaging results and PSA, help determine how much cancer is present and guide a personalized treatment plan.
If you’re experiencing urinary symptoms such as frequent urination, weak urine flow, or discomfort, please call our clinic to schedule an evaluation with an Arkansas Urology doctor. However, prostate cancer can be present even in the absence of symptoms.
The Prostate Cancer Staging System
Cancer staging—sometimes called staging—describes how prostate cancer is and whether it has spread beyond the prostate. Arkansas Urology uses the TNM staging system, which evaluates:
- Tumor (T): Size and extent, including whether the tumor has crossed the prostate capsule.
- Nodes (N): Whether the cancer has spread to lymph nodes, including any spread to nearby lymph or nearby lymph nodes.
- Metastasis (M): Whether the cancer has spread to bones, distant organs, or distant lymph nodes.
Your doctor will also consider your PSA level, Gleason score, and overall clinical staging results. Risk categories (low risk, high risk, or very high risk) reflect tumor features and help the medical team select a primary treatment.
The Stages of Prostate Cancer
Stage I – Localized, Early Stage
Stage I prostate cancer is small and confined within the prostate gland. PSA levels are typically low, and the Gleason score suggests a slow-growing tumor. Many men in this stage do not experience symptoms, and the disease is often discovered through prostate cancer screening or a prostate-specific antigen test. This stage is sometimes called localized prostate cancer or early prostate cancer.
Treatment for Stage I may include active surveillance, where the cancer care team closely monitors PSA levels, prostate biopsy results, and imaging at set intervals, or curative options such as radiation therapy or surgery. Because cancer is limited to the prostate and has not spread to lymph nodes or other organs, outcomes are excellent for more than half of patients.
Stage II – Locally Advanced, Higher Grade
At this stage, the cancer remains within the prostate but shows more aggressive characteristics. The tumor may involve more areas of the prostate gland, and PSA levels and Gleason scores are elevated. Stage II belongs to a higher risk group, and treatment is typically more proactive.
Treatment options may include radical prostatectomy, external beam radiation therapy, or hormone therapy to control tumor growth. The goal is to eliminate the cancer while preserving urinary and sexual function when possible. Arkansas Urology’s cancer doctor will explain benefits and risks, including when observation is reasonable for low risk patients and when combination therapy is preferred for high risk or very high risk features.
Stage III – Spread to Nearby Tissues
In Stage III, prostate cancer has spread beyond the prostate capsule to nearby tissues, such as the seminal vesicles, nearby lymph nodes, or tissue around the gland. This stage is referred to as locally advanced prostate cancer. Imaging often shows how far cancer spreads within the pelvis, but not to distant sites.
Treatment for Stage III may combine radiation therapy, hormone therapy, and sometimes surgical removal of the prostate. Select patients benefit from targeted therapy based on tumor biology. With coordinated care and a clear treatment plan, many patients achieve long-term control even when cancer extends beyond the prostate.
Stage IV – Metastatic or Advanced Prostate Cancer
In Stage IV prostate cancer, it has spread to distant lymph nodes, bones, or other organs—often distant organs such as the spine or liver. This is often called advanced prostate cancer or stage IV prostate cancer (often shortened to stage IV). At this point the disease is systemic. While metastatic prostate cancer is not curable, many therapies can control it for years.
Treatment for metastatic cancer may include hormone therapy, chemotherapy, targeted therapy, and enrollment in clinical trials. Care focuses on slowing progression, relieving symptoms, and supporting quality of life. Arkansas Urology’s medical team coordinates therapy across specialties so patients understand options and remain active in decision‑making.
How Doctors Determine the Stage
To determine the correct stage, Arkansas Urology’s team performs a detailed assessment using a combination of imaging tests and laboratory evaluations. These define whether disease is localized, regionally advanced, or metastatic—and whether there is spread to nearby lymph structures or to distant sites.
We typically perform:
- MRI and CT scans to evaluate tumor size, capsular involvement, and spread within the pelvis.
- Bone scans to identify whether cancer has spread to bones or joints.
- Review of prostate biopsy results to study tumor cells, prostate tissue architecture, and grade group.
- Lymph node sampling to determine involvement of nearby lymph nodes and distant lymph nodes.
- Initial staging in the clinic, followed by pathological staging when surgery is performed.
This process—guided by PSA, DRE findings, and imaging—shows how much cancer is present and where it is located in relation to the prostate. The information shapes a personalized treatment plan and helps decide the best primary treatment.
Treatment Options by Stage
Treatment varies by stage, overall health, and personal preference. At Arkansas Urology, patients have access to a full range of services under one roof:
- Surgical options such as radical prostatectomy and minimally invasive procedures.
- Radiation therapy using advanced technology to precisely target cancer cells.
- Hormone therapy to lower testosterone and slow cancer growth.
- Immunotherapy and targeted therapies for resistant or advanced cancers.
- Supportive therapies to manage urinary symptoms and help men who experience erectile dysfunction after treatment.
Our cancer care team coordinates every aspect of care to provide convenience, continuity, and confidence. Each plan is designed to match the stage, biology, and goals of the patient while protecting overall health.
Living With and Beyond Prostate Cancer
Living with prostate cancer requires comprehensive care before, during, and after treatment. Arkansas Urology offers long-term follow-up, PSA monitoring, and rehabilitation programs to help men manage side effects such as urinary incontinence or erectile dysfunction. We support lifestyle strategies—nutrition, activity, and stress control—that promote recovery.
About Arkansas Urology
Arkansas Urology is the state’s largest urology practice, serving patients across multiple locations. Our clinics are staffed by board‑certified urologists, surgeons, and specialized nurses with expertise in men’s health, cancer treatment, and preventive screening. As leaders in innovation, our team uses the latest staging system tools and therapies to provide personalized care.
Request an Appointment
Your prostate health matters. Arkansas Urology offers state‑of‑the‑art diagnostics, surgical options, and ongoing cancer care for patients throughout Arkansas. If you have questions about prostate cancer stages, diagnosis, or early detection, we encourage you to schedule an appointment online or call our clinic today to speak with a cancer doctor about your options.
