What is it? What are the complications? And what is the prognosis?

The Stages of Pancreatic Cancer

After the diagnosis of pancreatic cancer, the stage is determined.
The stage of pancreatic cancer is probably the most important factor to consider for the course of the treatment.

The Different Stages of Pancreatic Cancer

Clinical findings, biopsy and imaging studies are combined to assign a stage to the cancer.

T for tumor size, N for node involvement, and M for metastasis comprise the TNM system, and eventually get summed up in a staging system.

  • Stage 0 – Cancer found only in the lining of the pancreas
  • Stage I – Cancer limited to the pancreas
    • Stage IA – Tumor size is 2 centimeters or less
    • Stage IB – Tumor size is more than 2 centimeters
  • Stage II – Cancer has spread to nearby organs and tissues (duodenum, bile duct etc.)
    • Stage IIA – Cancer has spread to nearby organs, but no lymph node involvement
    • Stage IIB – Cancer has spread to nearby organs and lymph nodes
  • Stage III – Cancer has spread to the major blood vessels near the pancreas, irrespective of node involvement
  • Stage IV – Cancer has spread to stomach or distant organs

CT scan to determine the stage of pancreatic cancerThe higher the number, the more advanced the cancer is. However, this staging system can be difficult and sometime impossible to establish prior to surgery, because the exact location doesn’t always show up on a CT scan.

In addition, as if pancreatic cancer is not ominous enough, the TNM system can be difficult to understand and clasify.

Surgical Classification

A simpler staging system that facilitates understanding and provides a more practical standpoint is used by doctors. This system divides cancers into groups that are based on the possibility of being removed surgically.

  • Resectable cancers are localized in the pancreas and the entire tumor can be removed.
  • Locally advanced or unresectable tumors are yet to spread to distant organs but it cannot be completely removed, mostly because of surrounding blood vessels. For these cases, surgery can be done to relieve obstruction.
  • Metastatic cancer has spread to distant organs. Surgery may still be done but the goal is to relieve symptoms of obstruction but not to cure the cancer.

If the cancer is at an early stage, surgery can be curative. For advanced stages of pancreatic cancer, surgery is considered to relieve symptoms. Other options such as radiation and chemotherapy are available as well.
Overall, the aggressiveness of treatment is determined by the stage of pancreatic cancer, overall strength and health of the patient and the judgment of the oncologist.