Staging Of Pancreatic Cancer

As mentioned above most of the time when pancreatic cancer is diagnosed, it is found to be in a late stage of cancer because no screening test is available comparable to PSA for prostate cancer. However, this may change in the not too distant future. Unfortunately though for patients being diagnosed with pancreatic cancer now this translates into a poor survival outcome as the cancer has already spread into lymph glands along the aorta and into the retroperitoneal space. It often also has spread into adjacent organs and into the abdominal cavity. From there it is a very short distance into the blood stream and then into any organ system of the body (distant metastases).

Here is a summary of the TNM staging system adopted by the American Joint Committee for Cancer Staging (modified from p. 852, Ref. 1):

**Staging (TNM) of pancreatic cancer**
*Stage:*	*Comments regarding extent of cancer:*
I	Cancer localized to pancreas, may be extending directly to stomach, bile duct or duodenum, without regional LN *
II	Direct invasion into adjacent tissues without LN, but incompatible with surgical removal
III	Like stage III, regional LN as well, but no distant metastases
IV	Stage I-III findings, but also distant metastases

* LN stands for lymph node metastases

From a practical point of view this staging means those patients with stage I can be helped with surgery. In stage II the cancer is too advanced locally that it cannot be technically removed surgically. Stage III has regional lymph glands that are affected. Stage IV has distant metastases, a very poor prognostic sign.

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. Cancer: Principles &Practice of Oncology.4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter on Cancer of the pancreas.

2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Cancer of the pancreas.

3. T Nishihara et al. Jpn J Cancer Res 2000 Aug;91(8):817-824.

4. L Staib et al. Int J Cancer 2001 Apr 1;92(1):79-87.

Last Modified: Jan. 27, 2008