Staging & grading pancreatic cancer
Making an educated treatment decision begins with the stage, or progression, of the disease. The stage of pancreatic cancer is one of the most important factors in evaluating treatment options.
In order to examine the progression of the disease, your 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.
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.
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.