Pancreatic Cancer Stages / Staging | CTCA

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Video: Cancer Staging

Dr. Timothy McCay explains what the stages of cancer mean and how this information is determined. He also discusses why determining the stage of cancer is critical to treatment planning.

Cancer Staging

Dr. Timothy McCay explains what the stages of cancer mean and how this information is determined. He also discusses why determining the stage of cancer is critical to treatment planning.

In order to examine the progression of the disease, your CTCA doctor may use several tools to determine if cancer growth extends beyond the pancreas. For example, your doctor may perform additional tests, such as a laparoscopy, chest X-ray or bone scan. A laparoscopy involves a small incision in the abdomen to closely explore the normality of the area. To ensure that the cancer is not in your chest, your doctor might also take a chest X-ray. Finally, a bone scan can tell whether or not cancer has spread to the bones.

Stages of Pancreatic Cancer

Once the test results are in, your doctor may assign one of the three pancreatic cancer stages to the disease:

Resectable: The tumor nodules can be removed.

Locally Advanced: The cancer has spread to areas surrounding the pancreas, such as tissues or blood vessels.
Metastatic: The cancer resides in multiple organs.

More on Classification

Sometimes, doctors use a classification system based on four numeric stages. This is known as the AJCC (American Joint Committee on Cancer) staging system and is used for a variety of different cancer types, including pancreatic cancer.

Using this pancreatic cancer staging system, doctors differentiate when the disease has spread to the tissue surrounding the pancreas (stage II) and when cancer has reached the blood vessels near the pancreas (stage III). This system still acknowledges the advanced stage of pancreatic cancer as metastatic.

Other times, a grade level is given to pancreatic cancer. Much like the stages of pancreatic cancer, grades help classify how aggressive the tumor is, and how likely it is to grow and spread to surrounding tissue and other locations in the body. Grade levels range between 1 and 4 with G1 (grade 1) denoting cancers that look similar to normal cells, and G4 (grade 4) denoting cancer cells that are highly abnormal in appearance.

The TNM System of Pancreatic Cancer Staging

The pancreatic cancer staging process often uses the AJCC TNM system, which uses three criteria to judge the stage of the cancer: the size and location of the primary tumor (T), the adjacent lymph nodes (N) and if the tumor has spread to the rest of the body (M).

Primary Tumor (T)

TX - Primary tumor cannot be assessed.
T0 - No evidence of primary tumor.
Tis - Carcinoma in situ.
T1 - Tumor limited to pancreas, 2 cm or less in greatest dimension.
T2 - Tumor limited to pancreas, more than 2 cm in greatest dimension.
T3 - Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery.
T4 - Tumor involves the celiac axis or the superior mesenteric artery (unresectable primary tumor).