Stage IV Prostate Cancer
Stage IV represents the most advanced form of prostate cancer and is further categorized into two subgroups. At this point, the cancer can have any Grade Group, Gleason score, or PSA level.
By this stage, prostate cancer has typically spread to distant areas of the body, including other organs or bones. This stage, known as Stage IV, is the most advanced form of the disease. When prostate cancer reaches this level of progression, the 5-year survival rate drops significantly, falling to around 30% if distant metastasis is confirmed. At this stage, treatment focuses more on managing symptoms, slowing the cancer’s progression, and improving the quality of life rather than curative treatment. Early detection and intervention remain crucial to improving outcomes.
IV A
Prostate Cancer: Any T, N1, M0
At this stage, the tumor may or may not have grown into nearby tissues (any T), but the cancer has spread to nearby lymph nodes (N1). However, it has not spread to distant parts of the body (M0).
This classification allows for any Grade Group, any Gleason score, and any PSA level, reflecting a range of tumor aggressiveness. While the cancer is more advanced due to lymph node involvement, it is still considered regionally spread rather than metastatic.
IV B
Prostate Cancer: Any T, Any N, M1
At this stage, the cancer is classified as metastatic, meaning it has spread beyond the prostate to distant parts of the body (M1)—such as the bones, distant lymph nodes, or other organs. The tumor may or may not have grown into nearby tissues (any T) and may or may not involve nearby lymph nodes (any N).
The Grade Group, Gleason score, and PSA level can be any value, as this stage encompasses a wide range of disease characteristics. Once prostate cancer has reached this stage, it typically requires systemic treatment and long-term management strategies.