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"Stage" is the word doctors use to describe the size of a cancerous tumor and where and how far it has spread:
Primary site or primary tumor: The first place cancer is found in the body.
Metastatic cancer: When a cancer spreads to distant parts of the body.
Learn about how we determine the stage of the cancer and what the different stages mean:
The TNM System for Staging Pancreatic Cancer
The TNM System is a standard system for describing the extent of a cancer's growth. This system was developed by the American Joint Committee on Cancer (AJCC). TNM refers to:
T (tumor): The size of the original tumor and whether or not it has invaded nearby organs.
N (node): Whether the lymph nodes in the area of the original tumor have become cancerous.
M (metastasis): Whether the cancer has spread to other, distant organs in the body, such as your bones, liver or lungs.
Stage Groupings of Pancreatic Cancer
The AJCC TNM classification defines cancers by Roman numbers 0 through IV. To determine the stage of your cancer, your doctor first assigns numbers for the T, N and M groups. These numbers are then combined in a process called stage grouping to give the cancer an overall stage. The lower the number, the less the cancer has spread. The higher the number, the more the cancer has spread.
The stages of pancreatic cancer are:
Stage 0: The tumor is only in the top layer of the pancreatic duct cells and has not invaded deeper. This is usually called pancreatic cancer in situ.
Stage IA: Cancer is only found in the pancreas and is no larger than two centimeters across. The cancer has not spread to the lymph nodes or to distant parts of the body.
Stage IB: Cancer is only found in the pancreas and is larger than two centimeters across. The cancer has not spread to the lymph nodes or to distant parts of the body.
Stage IIA: The cancer has spread to other areas near the pancreas. It has not spread to nearby lymph nodes, to major blood vessels or to distant sites.
Stage IIB: The cancer may or may not have spread to nearby areas. It has spread to nearby lymph nodes, but has not spread to nearby major blood vessels or nerves or to distant parts of the body.
Stage III: The cancer has spread to nearby major blood vessels or nerves and may have spread to nearby lymph nodes, but it has not spread to distant sites.
Stage IV: The cancer has spread to organs further away from the pancreas. This might include the liver, lining of the abdomen (called the peritoneum) or the lungs.
Pancreatic Cancer Stages: Resectable, Locally Advanced and Metastatic Cancer
While we use the TNM system to formally stage pancreatic cancer, there is a simpler system we use when determining the best treatment. We divide these cancers into three groups:
Resectable pancreatic cancer: These cancers can be surgically removed (resected). This includes many cancers that are still confined within the pancreas or have grown just outside of it.
Locally advanced pancreatic cancer: The cancer is only in the area around the pancreas, but it cannot be removed completely with surgery. Often this is because the cancer is growing into nearby blood vessels. Because the tumors can't be removed with surgery, they are also called unresectable.
Metastatic pancreatic cancer: The cancers have spread to distant parts of the body, so they cannot be removed completely with surgery (unresectable).
Pancreatic Cancer Treatments
We will work with you to determine the most effective treatment options. This may include medication, chemotherapy, radiation therapy or surgery. Learn more about pancreatic cancer treatments.
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.
Open trials refer to studies currently accepting participants. Closed trials are not currently enrolling, but may open in the future.