Staging

Once pancreatic cancer is diagnosed, the cancer can be staged to helps doctors and patients create the best possible treatment plans that extend survival and maintain quality of life.

Staging ties together information about a tumor’s size, location and spread to create a simple classification system that goes from 0 (most treatable) to 4 (least treatable).

Stages

Stage 0 describes tumor cells that have not spread out from their starting point.  This is sometimes thought of as “pre-cancer,” or called by its technical name “Carcinoma in situ.”  

  • Stage 0 tumors can usually be removed with surgery.

 Stage 1 cancers are small and haven’t spread outside of the pancreas.  Depending on the exact size of the tumor, it may be called Stage 1A or Stage 1B.

  • Stage 1A: The tumor is 2 centimeters or smaller
  • Stage 1B: The tumor is larger than 2 centimeters

Stage 1A and 1B tumors can usually be removed with surgery.

Stage 2 cancers have spread to organs neighboring the pancreas but not to blood vessels or distant organs.  It is divided into Stage 2A and Stage 2B, depending on whether it has spread to the nearby lymph nodes.

  • Stage 2A: The tumor has not spread to nearby lymph nodes
  • Stage 2B: The tumor has spread to nearby lymph nodes

Stage 2A and 2B tumors can usually be removed with surgery.

Stage 3 cancers have spread to nearby blood vessels, but they have not spread to distant organs.

  • Stage 3 tumors can sometimes be removed with surgery after chemotherapy.

Stage 4 cancer has spread outside of the pancreas to distant parts of the body. 

  • Stage 4 tumors cannot be removed with surgery.  Chemotherapy offers the best therapy for these tumors.

Surgical Classification

Sometimes instead of staging, doctors will classify tumors with these terms:

Resectable: This type of cancer can be surgically removed. 

Borderline: This type of cancer touches or surrounds nearby veins. After chemotherapy and radiotherapy, these tumors can often be removed with reconstruction of the vessels.  Borderline tumors have not spread to distant parts of the body. 

Locally Advanced: This type of cancer cannot be surgically removed with traditional methods because it has invaded nearby blood vessels. After chemotherapy and radiotherapy, these tumors can sometimes be removed with reconstruction of the vessels.  Locally advanced tumors have not spread to distant parts of the body. 

Metastatic: This type of cancer cannot be surgically removed because the cancer has spread to other parts of the body. Unfortunately, nearly half of all pancreatic cancer cases are detected at this stage.