A prostate cancer stage defined by the Jewett staging system. Stage D prostate cancer is cancer that began in the prostate and has spread to lymph nodes near or far from the prostate, or to other parts of the body, often to the bones. Stage D is divided into stages D0, D1, D2, and D3. In stage D0, the level of prostatic acid phosphatase (PAP) is high. In stage D1, the cancer has spread to local lymph nodes only. In stage D2, the cancer has spread to distant lymph nodes and to bones or internal organs. In stage D3, prostate cancer has come back in patients who had received hormone therapy.