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Staging means finding out how far pancreatic cancer has spread in your body. Physicians group pancreatic cancer into stages I (1) through IV (4), with stage I being the least advanced and stage IV being the most advanced. If there are abnormal cells on the lining of your pancreas that are not cancer but might turn into cancer, it might be called stage 0.
When your Fred Hutch Cancer Center team designs your treatment plan, they will take into account the stage of your cancer along with many other factors. Importantly, the team will consider if a surgeon can remove the cancer (it’s resectable) or not (called unresectable).
The stage depends on:
- The size of the tumor
- If cancer is only in the pancreas
- Where it has spread if it has gone beyond the pancreas
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Pancreatic Cancer Stages
Here’s what each stage means in more detail:
Stage I (1)
Cancer is only in the pancreas.
- Stage IA: The tumor is 2 centimeters (cm) across or smaller.
- Stage IB: The tumor is larger than 2 cm but not larger than 4 cm.
Stage II (2)
Tumor is larger and has spread to nearby lymph nodes.
- Stage IIA: The tumor is larger than 4 cm across.
- Stage IIB: Cancer has spread to one to three nearby lymph nodes.
Stage III (3)
Cancer has spread to four or more nearby lymph nodes or to major blood vessels near the pancreas.
Stage IV (4)
Cancer has spread to other parts of the body, such as the liver, lungs, bones or lining of the abdomen (peritoneum).
How to Know Your Pancreatic Cancer Stage
After you are diagnosed with pancreatic cancer, your team will try to tell the stage based on an exam, imaging and sometimes other tests, like blood tests or a needle biopsy (putting a needle through your skin into the tumor to pull out cells for testing). This is called the clinical stage.
If your team recommends surgery as part of your treatment plan, they will check the tissues they remove as well as other tissue inside your body, which might lead them to refine or revise your stage. This is called the surgical stage or pathological stage. Sometimes, care teams recommend surgery specifically to get more details for staging (exploratory surgery) before deciding on a treatment plan.
Pancreatic Cancer Survival Rates
In cancer care, “survival rate” usually means the percentage of people expected to survive their cancer for at least five years from the time it was diagnosed. Data experts estimate this rate based on information about large groups of people with the same type of cancer. The rate doesn’t include the risk of dying during that five years for some other reason.
But the chance of surviving cancer for five years or more can be quite different from person to person. One important reason is the stage of the disease at the time of diagnosis. Even within a subset of people, like those with localized disease, there will be differences. Patients may have different treatments and respond to treatments in different ways.
This means it’s impossible to predict the likely lifespan of any one person based on survival rates. If you would like to know more about the outlook for your disease, talk with your Fred Hutch care team. They can tell you more based on your unique situation.
In general, people who have the same stage of cancer often have the same or similar treatments. In pancreatic cancer, the main consideration is if the cancer can be completely removed with surgery. From there, your care team will look at other factors, including the stage and your overall health, to put together a personalized treatment plan for you.
Here are common treatment groupings:
- Resectable: A surgeon can remove your tumor. You might have chemotherapy, other medicines, radiation therapy or a combination of these treatments before or after surgery to get the best results.
- Borderline resectable: It would be difficult to remove all the tumor safely as it is. You’ll have chemotherapy, other medicines, radiation therapy or a combination first to try to shrink the tumor. Then surgery might be possible.
- Locally advanced: A surgeon cannot remove all of the tumor because it has spread outside the pancreas to nearby tissues, like blood vessels or lymph nodes. You’ll have other types of treatment. Sometimes surgery becomes an option after other treatments help control the disease.
- Metastatic/unresectable: Because cancer has spread beyond the local area, surgery isn’t a good option. Instead, you might have chemotherapy, other medicines, radiation therapy or a combination of these treatments.
Learn more about pancreatic cancer treatment.
Researchers at Fred Hutch and beyond are always looking for better ways to treat advanced pancreatic cancer. Clinical trials are going on to test new drugs or new combinations of drugs as well as methods to deliver radiation directly to cancer cells.
Two important areas of research are targeted therapies and immunotherapies. Targeted therapies are newer cancer treatments that work more selectively than standard chemotherapy. Immunotherapies use the power of your immune system to fight your cancer.
Among the immunotherapies being studied for pancreatic cancer are engineered T cells (a type of immune cell) and a vaccine to help the immune system see and destroy cancer.
Learn more about pancreatic cancer treatment.