Course Content
1. Introduction to Prostate Cancer
o Understanding the prostate gland o Overview of prostate cancer o Risk factors and epidemiology
2. Signs and Symptoms
o Common signs and symptoms o When to seek medical attention o Diagnostic tests and screening guidelines
3. Diagnosis and Staging
o Biopsy procedures and interpretation o Staging techniques (TNM system) o Imaging modalities for staging
6. Nutrition and Lifestyle Considerations
o Diet and nutrition recommendations o Exercise and physical activity guidelines o Stress management techniques
Understanding Prostate Cancer: Online Course for Patients & Caregivers
About Lesson


Staging is a crucial aspect of prostate cancer management, as it helps determine the extent of the disease and guides treatment decisions. The TNM staging system, developed by the American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC), is widely used to stage prostate cancer based on tumor size, lymph node involvement, and metastasis.

TNM Staging System:

  1. Tumor (T) Stage:

    • T1: The tumor cannot be felt during a digital rectal exam (DRE) and is not visible on imaging tests.
    • T1a: Small, incidental tumors found in less than 5% of prostate tissue removed during surgery for other reasons.
    • T1b: Small tumors found in more than 5% of prostate tissue removed during surgery for other reasons.
    • T1c: Tumors detected by needle biopsy performed due to elevated prostate-specific antigen (PSA) levels, but not palpable on DRE.
    • T2: The tumor is confined to the prostate gland but can be felt during a DRE or seen on imaging tests.
    • T2a: The tumor involves one-half or less of one lobe of the prostate.
    • T2b: The tumor involves more than one-half of one lobe but not both lobes.
    • T2c: The tumor involves both lobes of the prostate.
    • T3: The tumor extends beyond the prostate capsule but has not invaded nearby structures.
    • T3a: The tumor extends through the prostate capsule but not into the seminal vesicles.
    • T3b: The tumor invades the seminal vesicles.
    • T4: The tumor has spread to nearby structures such as the bladder, rectum, or pelvic wall.
  2. Node (N) Stage:

    • N0: No regional lymph node metastasis.
    • N1: Metastasis to regional lymph nodes.
  3. Metastasis (M) Stage:

    • M0: No distant metastasis.
    • M1: Distant metastasis present.
      • M1a: Metastasis to non-regional lymph nodes.
      • M1b: Metastasis to bone.
      • M1c: Metastasis to other sites.

Determining Overall Stage:

The overall stage of prostate cancer is determined by combining the T, N, and M stages:

  • Stage I: T1 or T2, N0, M0
  • Stage II: T1 or T2, N0, M0
  • Stage III: T3 or T4, N0, M0
  • Stage IV: Any T, N1 or M1

Online Resources for Further Learning:

Explore the following online resources to learn more about the TNM staging system for prostate cancer:

End of Topic Quiz:

  1. Which TNM stage indicates that the tumor has extended beyond the prostate capsule but has not invaded nearby structures?

    • A) T1
    • B) T2
    • C) T3
    • D) T4

    Answer: C) T3

  2. What is the overall stage of prostate cancer if the tumor is confined to the prostate gland, there is no regional lymph node metastasis, and there is no distant metastasis?

    • A) Stage I
    • B) Stage II
    • C) Stage III
    • D) Stage IV

    Answer: A) Stage I

Takeaway Assignment:

Assign students to research and present on one specific TNM stage of prostate cancer, detailing the characteristics of the stage, prognosis, and treatment options. Encourage students to use visual aids such as diagrams or charts to illustrate key points and facilitate understanding. This assignment will help reinforce knowledge of the TNM staging system and its clinical implications in prostate cancer management.

Join the conversation