Stages

What Are the Stages of Pancreatic Cancer?

Staging is the term oncologists use to define where pancreatic cancer is located and how much it has spread. Once the stage of pancreatic cancer is determined, your physician can recommend a particular course of treatment.

Most cancer teams use the system developed by the American Joint Committee on Cancer, known as the TNM staging system.

T = Tumor: Where is the primary tumor and how large is it?

N = Nodes: Has the tumor spread to nearby lymph nodes?

M = Metastasis: Has cancer spread to other parts of the body?

For each letter, there are five numbered stages, from 0 to 4, depending on how much the cancer has spread. The lower the number, the more the cancer cells look like normal cells and the easier they are to treat and cure. A higher number means it has spread more deeply.

The place where cancer originates is called the primary site. Cancer can spread from the primary site to other parts of the body. It’s important to understand that even if pancreatic cancer is found in other parts of your body, it’s still considered pancreatic cancer. For instance, if colon cancer has spread to the liver, it’s called metastatic colon cancer, not liver cancer.

For purposes of treatment, physicians often use a simpler system of categorizing pancreatic cancer:

  • Resectable cancer: These cancers can be surgically removed (resected). This includes many cancers that are still confined within the pancreas or have grown just outside of it.
  • Borderline resectable cancer: These cancers can be surgically removed but are very close to major blood vessels.
  • Locally advanced cancer: These cancers are still only in the area around the pancreas, but they cannot be removed completely with surgery, often because they are growing into nearby blood vessels. Because they can't be removed with surgery, they are also called unresectable.
  • Metastatic cancer: These cancers have spread to distant parts of the body, so they cannot be removed completely with surgery (that is, they are also unresectable). Surgery may still be done, but it's used to relieve symptoms, not cure the cancer.

Be sure to talk to your physician about your particular stage of cancer and how that will impact your treatment.

For more information about the stages of pancreatic cancer, please visit our Health Library.