Diagnosis - Jewett-Whitmore classification system

Classification

The tumor is “classified” according to the form, the characters of the cells and the extension of the metastasis. There are two classification systems for prostate tumors: the TNM (Tumors, Nodes, Metastasis) System and the Jewett-Whitmore System.

Jewett-Whitmore System

With this system the prostate tumor is classified as Stage A, B, C or D.

The A and B Stages are considered curable. The C and D stages are treatable, but their prognosis is not encouraging. In addition, there is assigned a number to describe more specifically each Stage. For example, a tumor classified as phase B1 is a single nodule of the tumor limited to a lobe of the prostate.

Stage A
This is an initial phase, without symptoms; the tumor cells are limited to the prostate.

A1 Tumor cells differentiated or slightly abnormal.

A2 Tumor cells moderately or slightly differentiated compared to the normal ones, and abnormal in various positions inside the prostate.

Stage B
The tumor is limited to the prostate but palpable (detectable in a rectal examination) and/or detectable by an elevated PSA.

B0 limited to the prostate, not detectable; high PSA.

B1 a single tumor nodule in a prostate lobe.

B2 diffused, involves one or both lobes of the prostate.


Stage C
The tumor cells are found outside the prostate capsule (the membrane that covers the prostate); diffusion limited to surrounding tissues and/or seminal vesicles.

C1 extends outside the prostate capsule.

C2 obstruction of the urethra or the bladder.

Stage D
Metastasis (diffusion) to the regional lymph glands, or at a distance from the bones, organs (liver, lungs) and/or other tissues.

D0 Clinically localized to the prostate but metastasized, high level of PAP in the blood.

D1 Regional lymph glands involved.

D2 Involvement of the distant lymph glands, the bones and the organs.

D3 Metastatic illness.