Staging is a natural and necessary tool in treating and managing cancer of all types, including pancreatic cancer. Understanding the staging process helps you and your doctor determine a customized treatment plan that works for your specific needs. Learn more about pancreatic cancer and its stages below.
What is Pancreatic Cancer?
Pancreatic cancer refers to any cancer that starts in the cells of the pancreas. The pancreas sits just behind the lower stomach. It secretes enzymes that help with digestion and absorb nutrients, and it produces hormones, particularly insulin, that help to manage blood sugar levels.
What are the signs of pancreatic cancer? Pancreatic cancer symptoms can vary from patient to patient and usually are not noticeable until the disease has advanced to later stages. Some of the most common pancreatic cancer symptoms and signs include:
- Yellowing of the skin and eyes (known as jaundice)
- Pain in the abdomen that radiates to your back
- Blood clots
- Light-colored stools
- Dark urine
- Blood clots
Pancreatic adenocarcinoma is the most common type of pancreatic cancer. Pancreatic adenocarcinoma starts in the exocrine cells, which form the exocrine glands and ducts that produce and release digestive enzymes.
There is not necessarily a straightforward answer to the question, “What is the one cause of pancreatic cancer?” Pancreatic cancer is primarily caused by genetic mutations, which can be hereditary or a result of exposure to certain environmental factors.
What are the Stages of Pancreatic Cancer?
Following a positive diagnosis of the disease, the doctor will proceed to the staging process. This is important as it determines if the primary tumor has become a metastatic tumor, meaning it has spread to other parts of the body, and, if so, the extent of that spread. This can then inform the types of pancreatic cancer treatment options that you receive.
Staging starts with a numbering system ranging from stage 0 to stage IV. The higher the number, the more advanced pancreatic cancer is and the farther that it has spread. Stage 0 is sometimes referred to as carcinoma in situ, meaning that the cells are precancerous in a limited area. However, it is often difficult to identify the beginning stages of pancreatic cancer as the disease rarely presents itself until it has reached more advanced stages.
Along with the number system, staging for pancreatic cancer also uses the TNM system:
- T denotes cancers that are relegated to localized tumors.
- N refers to cancers that have spread to nearby lymph nodes.
- M refers to cancers that have metastasized (spread to distant organs or lymph nodes).
The stage combines the number and the TNM designation. Stage III T1 N2 M0, for example, refers to cancer that is confined to the pancreas with a primary tumor measuring no more than 0.8 inches across and spread to at least four nearby lymph nodes but without any metastasis to distant sites.
Other prognostic factors can also play a role in determining the stage and potential outlook. The pancreatic tumor grade determines the way that pancreatic tissue looks under a microscope.
- With grade 1, the cancer looks like normal pancreatic tissue.
- Grade 3 is a cancer that looks decidedly abnormal under the microscope.
- Grade 2 tumors look like something in between.
Lower-grade cancers tend to grow and spread at a slower rate than higher-grade cancers.
Resectable vs. Unresectable
While the above staging is important in providing a summary of the cancer’s spread, doctors will use a simpler staging system for treatment purposes. This system divides the pancreatic cancer into groups based on whether the cancer cells can be removed via surgery (resected).
Cancers that are relegated to just the pancreas and appear to be fully removable are considered resectable. However, some tumors may only appear resectable at first. Upon surgery, the doctor may notice that the pancreatic tumor may not be fully removable. Borderline resectable tumors have reached nearby blood vessels, but surgical removal may still be possible. An unresectable tumor cannot be removed at all. This may be because it is a metastatic tumor that has grown into a major blood vessel(locally advanced) or spread to distant organs.
Later or final stages of pancreatic cancer can be harder to treat, so it’s important to get a proper diagnosis as soon as possible. In terms of what is the survival rate for pancreatic cancer, the sooner you receive pancreatic cancer treatment, the better the outcome. Common treatment options include targeted therapy, radiation therapy, and chemotherapy.