Pancreatic Cancer Overview

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Early Detection, Diagnosis, and Staging TOPICS

Staging for pancreatic cancer

Staging is the process of finding out how widespread the cancer is and whether it has spread to other parts of the body. This is very important because the treatment and the outlook for the patient depend on the stage of the cancer. The tests described in the section “How is pancreatic cancer found?” are used to decide the stage of the cancer.

In the AJCC (American Joint Committee on Cancer) staging system, stages of exocrine pancreatic cancer are labeled using Roman numerals I through IV (1 - 4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more advanced cancer.

Other factors

Although not part of the AJCC staging system, some other factors are also important. The grade of the cancer (whether the cells look more or less normal under the microscope) is sometimes listed on a scale from G1 to G4, with G1 cancers looking the most like normal cells and having the best outlook.

For patients who have surgery, the extent of the resection — whether or not all of the tumor is removed — is also important with regard to outlook. This is sometimes listed on a scale from R0 (where all of tumor that can be seen has been removed) to R2 (where some tumor could not be removed).

Terms used to describe pancreatic cancer

From a practical standpoint, how far the cancer has spread often can’t be known for sure without surgery. That’s why doctors often use a simpler staging system which divides cancers into groups based on whether or not it is likely they can be removed by surgery. These groups are listed below.

Resectable: The cancer is mostly in the pancreas and all of it can be removed.

Locally advanced (unresectable): The cancer has spread to tissue and blood vessels around the pancreas but not to distant organs. The doctor cannot remove all of the cancer. Surgery would be done only to relieve symptoms or other problems.

Metastatic: The cancer has spread to distant organs. Surgery would be done only to relieve symptoms or other problems.

Last Medical Review: 02/15/2013
Last Revised: 02/03/2014