Advanced Prostate Cancer
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T3 N1 M0. that stage 3 or 4 ??

Maybe someone can help clarify .....

I had lymph node involvement from diagnosis but nothing beyond the local area has ever been found after numerous scans including Axumin scan 8 months ago.

2 years ago they told me I was stage 3 and said I was T3n1m0 .

Yet , I have read so many things describing ANY lymph node involvement as stage 4 .

Who is right ?

I’m just curious ..... it doesn’t affect my treatment plan .

Live long Live strong !

5 Replies

It's confusing because there are two AJCC-standard meanings for the word "stage." One meaning is the "T" stage, which is designated with an arabic numeral and combined with info about lymph nodes and distant mets - T3 (a or b) N1 M0. The other meaning refers to the AJCC Cancer Prognostic Stage Grouping, and is always designated with a roman numeral. Anyone who is N1 is stage IV (regardless of T stage). Because you are N1 and M0, you are designated as stage IVA. I think it's more informative and clearer to use the NCCN designation "locally advanced."


Yup. Locally advanced is the designation my husband was told when we asked about staging. Both the MO and RO used that terminology but said other oncologists would call it IVA. We were also told that treatment is potentially curative; in husband’s case, Lupron and Casodex started and will last 18 months. After 60 days of ADT, he will have 40 sessions of EBRT (possibly IMRT after evaluation first week of May) Radiation will begin mid-May.

We were doing a happy dance with news of IVA because it’s possibly curable. My spouse has one left node and 2 probable right nodes involved. We had been led to believe by a urologist that only palliative ADT was possible. He went to a university cancer center for oncology consults. Those doctors explained that the locally advanced term makes it clear that there are no distant mets (IVB) to be seen; thus making potentially curative treatments available.

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Awesome !!!! I am wishing you all the best !!!!

Live long live strong !!!!


Thank you so much for the detailed reply ! You are a constant source of amazing information for everyone here . Thank you Allen !


G9: stages 0-3 are considered localized cancer, and when local lymph tissue is involved, it generally means “ localized “ advanced cancer in stages described as stage 2 or 3. Stage 4 cancer generally describes metastasis reserved for cancer that has spread beyond the local margins, as in stages 1,2,3, to distal ( beyond local) regions. So if lymph tissue is involved beyond the original primary cancer site, that then would be considered a stage 4 cancer. Stan AZ/AK.

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