Once pancreatic cancer is diagnosed, it is “staged.” Pancreatic cancer is broken into four stages with stage 1 being the earliest stage (stage 0 is not counted) and stage IV being the most advanced (metastatic disease). The following are the stages of pancreatic cancer according to the National Cancer Institute:
Stage 0: Cancer is found only in the lining of the pancreatic ducts. Stage 0 also is called carcinoma in situ.
Stage I: Cancer has formed and is in the pancreas only.
- Stage IA: The tumor is 2 centimeters or smaller.
- Stage IB: The tumor is larger than 2 centimeters.
- Stage II: Cancer may have spread to nearby tissue and organs and lymph nodes near the pancreas.
- Stage IIA: Cancer has spread to nearby tissue and organs but has not spread to nearby lymph nodes.
- Stage IIB: Cancer has spread to nearby lymph nodes and may have spread to other nearby tissue and organs.Stage IV: Cancer may be of any size and has spread to distant organs, such as the liver, lung, and peritoneal cavity. It also may have spread to organs and tissues near the pancreas or to lymph nodes.Patients with stage I and stage II cancers are thought to have local or “respectable” cancer (cancer that can be completely removed with an operation). Patients with stage III cancers have “locally advanced, unrespectable” disease. In this situation, the opportunity for cure has been lost but local treatments such as radiation remain options. In patients with stage IV pancreatic cancer, chemotherapy is most commonly recommended as a means of controlling the symptoms related to the cancer and extending life. Below, we will review common treatments for the three groups of pancreatic cancers (respectable, locally advanced unrespectable, and metastatic pancreatic cancer).
- Unlike many cancers, however, patients with pancreatic cancer are typically grouped into three categories, those with local disease, those with locally advanced, unrespectable disease, and those with metastatic disease. Initial therapy often differs for patients in these three groups.
- Stage III: Cancer has spread to the major blood vessels near the pancreas and may have spread to nearby lymph nodes.