Stages of Pancreatic Cancer
What is Cancer Staging?
Cancer staging is the process of determining how much cancer is in the body and where it is located. Staging describes the severity of an individual's cancer based on the magnitude of the original (primary) tumour as well as on the extent cancer has spread in the body. Understanding the stage of cancer helps doctors to develop a prognosis and design a treatment plan for individual patients.
Staging is based on the clinical or radiological extent of disease, the pathological extent of disease after a tumour is removed. Restaging is when the process is repeated after a round of treatment.
How is Pancreatic Cancer Staged?
Clinical and radiological staging of pancreatic cancer is largely based on the appearance of the diagnostic tests undertaken. These may include a CT scan, MRI, Laparoscopy, endoscopic Ultrasound or PET scan. This is used to determine treatment.
The most common form of clinical staging is based on whether the pancreatic cancer is removable by surgery and whether it has grown into surrounding structures or spread to other organs. It is classified into 4 categories, but these are not the same as stage 1,2,3,4.
- Clearly Resectable – tumours clearly confined to the pancreas with no growth into adjacent blood vessels and no spread to other organs
- Borderline Resectable – These tumours are confined to the pancreas with no other spread but may have grown into adjacent blood vessels based on the scans performed
- Locally advanced – These tumours have not been proven t spread to other organs but significantly involve the major blood vessels around the pancreas
- Metastatic – Tumours that have been shown to spread to other organs or have been proven to spread to other organs by biopsy. (this is synonymous to stage 4 disease)
- Pathological Staging This staging system is based on more information than clinical staging and can only be fully determined once cancer has been removed. It is based on the size of the tumour, whether cancer has spread to lymph glands, grown into blood vessels or spread to other organs.
A simplified category of the pathological staging of pancreatic cancer is below
- Stage 1 – tumours that have not spread to lymph glands or other organs
- Stage 2 – A tumour that has spread beyond the pancreas or into up to 3 lymph glands
- Stage 3 – A tumour that has spread to more than 4 lymph glands or into the surrounding arteries
- Stage 4 – A tumour that has spread to other organs
