Several different staging systems are used for pancreatic cancer. Because pancreatic cancer stages can vary depending on the system a pathologist is using, it's important to talk about the implications of pathology findings with a doctor. The treatment plan is dependent on the stage of the cancer, and patients need to know what each of the pancreatic cancer stages actually means.
Cancer staging is a technique which is used to sort cancers to describe them in a uniform way. The staging is done by taking biopsy samples and medical imaging studies of the patient to determine what type of tumor is involved, how large the tumor is, and whether or not it has spread. In the case of pancreatic cancer, chemotherapy, radiation, and surgery can all be used in treatment, and the best treatment approach will vary, depending on the stage.
The American Cancer Society (ACS) uses the “TNM” system to describe cancers. T refers to “tumor,” and is assigned a number between 0 and four, depending on the size of the tumor. T can also be assigned “X,” meaning that the findings were indeterminate, or “IS,” for carcinoma in situ. N, for “node,” describes whether or not the lymph nodes are involved, while M for “metastases” refers to whether or not the cancer has spread to other organs. Pancreatic cancer stages under this system include: 0, IA, IB, IIA, IIB, III, and IV. IV, for example, might have a TNM like T3, N2, M1.
Another staging system sometimes used for pancreatic cancer stages includes I, II, III, IVA, and IVB. A pancreatic cancer at stage I is isolated to just the pancreas, while a stage IVB cancer has spread to the lymph nodes and distant organs. This staging system also includes a separate category for recurrent pancreatic cancer, cancer which has returned after treatment, and may be found in the pancreas or elsewhere in the body. Hospitals may also have their own pancreatic cancer stages which they use to describe cancers, including numbering and lettering systems.
As a general rule, the earlier the stage at which a cancer is caught, the better the prognosis for the patient. If a cancer can be caught before it begins to spread to the neighboring organs and into the lymphatic system, the patient stands a much better chance of survival. Understanding the pancreatic stages used by a pathologist to evaluate and categorize a cancer can be helpful for a patient when decisions need to be made about treatment.