You may have doubts about your diagnosis, may not understand the information you are given; are not happy with the treatment that has been recommended; or you may just want to talk to another doctor or specialist about your diagnosis or treatment.
Stages of pancreatic cancer
Staging shows how advanced the cancer is which is important to help doctors understand the best treatment decisions.
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You may hear of multiple methods or scales to measure the stage of pancreatic cancer but all aim to assess the size of the tumour, if it has spread to any other parts of the body nearby such as lymph nodes or blood vessels and if it has spread further to other organs or parts of the body.
Cancer is found only in the pancreas and has not spread to any organs next to the pancreas. This is known as early-stage disease.
A tumour that is confined to the pancreas and local lymph nodes (small bean-like structures near the pancreas) may be involved.
This is an inoperable tumour involving some large blood vessels. There may be spread to the lymph nodes near to the pancreas.
The cancer has spread to other organs, such as the liver, lungs or lining of the abdomen. This can be referred to as metastatic disease.
Treatments depending on the stage of your cancer
The treatments you have, and prognosis will ultimately be influenced by the stage of the tumour. Prognosis means the expected outcome of a disease. You will need to discuss your prognosis and treatment options with your specialists. However, it is not possible for any doctor to predict exactly what will happen. The sooner pancreatic cancer is diagnosed, the better the prognosis. This is because the cancer may have spread beyond the pancreas and treatment can be started earlier.
Stage one tumours can usually be surgically resected (removed). Surgeons can remove the tumour and surrounding tissue. Surgery for pancreatic cancer is a major operation and will be followed by treatments to try and stop the cancer from returning. These are called adjuvant treatments and often include chemotherapy. You may undergo a lengthy assessment to ensure that you are fit enough for surgery and your medical team should explain all of your treatment options to you. If surgery is not an option then other treatment options such as chemotherapy, radiotherapy or a clinical trial can be considered.
Stage two tumours may be locally advanced. They are often resectable or borderline resectable. Each case is different, but some tumours may be able to be removed after the use of neoadjuvant therapy such as chemotherapy or radiotherapy to shrink the tumour. If surgery is not possible then treatments will focus on stopping the tumour growing and shrinking it. This will aim to lengthen life and relieve any symptoms the tumour is causing. If surgery is not an option then other treatment options such as chemotherapy, radiotherapy or a clinical trial can be considered.
Stage three tumours are also locally advanced but may involve some large blood vessels and are much less likely to be resectable. Treatments will focus on slowing down the growth of the tumour and relieving any symptoms. These treatments focusing on quality of life are called palliative treatments and should involve a palliative care professional. Patients most frequently receive chemotherapy; this option should be discussed with you by your medical team. Clinical trials are another treatment option for patients with this tumour type.
Stage four tumours are metastatic and have travelled to other parts of the body. These tumours are not resectable and treatments will focus on slowing down the growth of the tumour and symptom management. These treatments focusing on quality of life are called palliative treatments and should involve a palliative care professional. Patients most frequently receive chemotherapy; this option should be discussed with you by your medical team. Clinical trials are another treatment option for patients with this tumour type.