Clinical findings, biopsy and imaging studies are combined to assign a stage to the cancer. T for tumor size, N for node involvement and M for metastasis comprise the TNM system, and eventually summed up in a staging system.

1. STAGES OF PANCREATIC CANCER
After the diagnosis of Pancreatic Cancer, the stage is determined. The stage of pancreatic cancer is
probably the most important factor considered for the course of the treatment.
PANCREATIC CANCER STAGE 0-IV
Clinical findings, biopsy and imaging studies are combined to assign a stage to the cancer. T for tumor
size, N for node involvement and M for metastasis comprise the TNM system, and eventually
summed up in a staging system.
 Stage 0 – cancer found only in the lining of the pancreas
 Stage I – cancer limited to the pancreas
Stage IA – tumor size is 2 centimeters or less
Stage IB – tumor size is more than 2 centimeters
 Stage II – cancer has spread to nearby organs and tissues (duodenum, bile duct etc.)
Stage IIA – cancer has spread to nearby organs but no lymph node
involvement
Stage IIB – cancer has spread to nearby organs and lymph nodes
 Stage III – cancer has spread to the major blood vessels near the pancreas,
irrespective of node involvement
 Stage IV – cancer has spread to stomach or distant organs
The higher the number, the more advanced the cancer is. However, this staging system can be
difficult and sometime impossible to accomplish prior to surgery. In addition, as if pancreatic cancer
is not ominous enough, the TNM system can be difficult to understand.
SURGICAL CLASSIFICATION
A simpler staging system that facilitates understanding and provides a more practical standpoint is
used by doctors. This system divides cancers into groups based on the possibility of being removed
surgically. Resectable cancers are localized in the pancreas and the entire tumor can be removed.
Locally advanced or unresectable tumors are yet to spread to distant organs but it cannot be
completely removed, probably because of surrounding blood vessels. For these cases, surgery can be
done to relieve obstruction. Metastatic cancer has spread to distant organs. Surgery may still be
done but the goal is to relieve symptoms of obstruction but not to cure the cancer.
If the cancer is at an early stage, surgery can be curative. For advanced stages, surgery is considered
to relieve symptoms and other modes such as radiation and chemotherapy are available. Overall, the
aggressiveness of treatment is determined by the stage of pancreatic cancer, overall strength and
health of the patient and the judgment of the oncologist.
For more information, please visit: http://www.whipple-procedure.org/stages-of-pancreatic-cancer/