Prostate Cancer Staging Calculator

Stage I: PSA < 10, Gleason ≤ 6, T1–T2a, N0, M0
Stage II: PSA 10–20, Gleason 7, T2b–T2c, N0, M0
Stage III: PSA > 20 or T3, any Gleason, N0, M0
Stage IV: Any T, Any Gleason, N1 or M1

Estimate the stage of prostate cancer using clinical indicators.

PSA Level (ng/mL): Gleason Score: T Stage: N Stage: M Stage:

Understanding Stage Grouping

Stage	Description	Details
T1	Not felt or seen on imaging	T1a: ≤5% of BPH tissue T1b: >5% of BPH tissue T1c: Detected by PSA biopsy
T2	Confined within prostate	T2a: ≤50% of one lobe T2b: >50% of one lobe T2c: Both lobes involved
T3	Extends outside the prostate	T3a: Capsule breached T3b: Seminal vesicle invasion
T4	Invasion of adjacent organs	Bladder, rectum, pelvic wall, etc.

Digital Rectal Exam (DRE): May detect abnormalities if tumor is palpable
Multiparametric MRI (mpMRI): 🔍 Best tool for local staging:
- Detects extracapsular extension (T3a)
- Seminal vesicle invasion (T3b)
- Organ invasion (T4)

PSMA PET-CT is not used to evaluate T stage but plays a vital role in staging overall prostate cancer:

N Staging: Detects small lymph node metastases missed on CT or MRI
M Staging: Highly sensitive for bone, lung, and liver metastasis (M1a/M1b/M1c)
Restaging: Useful in recurrent prostate cancer with very low PSA
Treatment Planning: Helps decide whether surgery or systemic therapy is appropriate

Note: mpMRI is required to assess the local extent of the primary tumor (T stage).