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Staging of Pancreatic Cancer

Once pancreatic cancer is diagnosed, it is important to determine the correct stage of the disease referring to whether, and how far, the cancer has spread in the pancreas and throughout the body. Determining the correct stage enables the physician to create the best treatment plan.

There are two ways to describe the stages of pancreatic cancer, by stage number or by surgical classification. Both systems are based on the size and location of the primary tumor, the involvement of local lymph nodes and blood vessels, and the extent of metastasis to other parts of the body. Your doctor may use one or both systems to describe the stage of the cancer.

Stage Number Classification

Stage number classification was developed by the American Joint Committee on Cancer (AJCC) and is used to stage all cancers, not just pancreatic cancer.

Stage 0: Carcinoma in situ. In situ is latin for "in its place." This stage describes precancerous conditions in which abnormal cells grow within the ducts or lining of the pancreas, but have not spread anywhere outside the place where they originate.
Stage I: In stage I, cancer has formed, but is confined to the pancreas only. Stage I is divided into stage IA and stage IB depending on the size of the tumor.
	Stage IA:	The tumor is 2 centimeters or smaller and found in the pancreas only
	Stage IB:	The tumor is larger than 2 centimeters and is found in the pancreas only
Stage II: In stage II, cancer may have spread to nearby organs but does not involve local blood vessels or distant parts of the body. This stage is also divided into two stages, stage IIA and IIB based on local lymph node involvement. Lymph nodes are where infection-fighting cells are produced and stored and are found all over the body.
	Stage IIA:	Cancer has not spread to local lymph nodes but has spread to nearby organs and tissue
	Stage IIB:	Cancer has spread to local lymph nodes and may have spread to nearby organs and tissue
Stage III: In stage III, cancer has spread to nearby blood vessels, but has not invaded distant organs or tissue. Cancer may or may not involve local lymph nodes in stage III.
Stage IV: The cancer has spread outside of the pancreas to other parts of the body.

Surgical Classification

The surgical classification method is simpler and more descriptive than the AJCC system, classifying tumors based on whether or not the tumor can be surgically removed.

Resectable: This type of cancer can be surgically removed. These tumors may lie within the pancreas or extend to nearby organs, but do not involve local blood vessels. When cancer is resectable, there is no evidence of any spread outside the tissue removed during surgery.

Locally Advanced: This type of cancer cannot be surgically removed with traditional methods because it has invaded nearby blood vessels or nearby organs. However, there is no evidence of 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.

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