Understand the
Pancreatic Cancer Stages

Most doctors start talking about the Pancreatic Cancer Stages almost as soon as they're done telling you that it's cancer.

For the doctor, this is the logical next step. It is standard medical protocol to determine the pancreatic cancer stage of each patient. Very clinical. Very important.

But incredibly hard for us to comprehend.

Probably because we were all so busy falling apart at the time. Pancreatic cancer staging was the last thing on our minds. We were still trying to wrap our heads and hearts around the prognosis. 

There were tears, there was shock, anger, even grief. There were prayers and bargaining. Panic and fear. But Pancreatic Cancer Stages? Hadn't crossed our minds. We just wanted to wake up from the nightmare.

So, Stages? How much worse can it be? You just said she had 3-6 months to live?

Well, back the cart up. If you or a loved one has just been given this devastating news, let me shed some hope on a seemingly hopeless prognosis.

Staging the pancreatic cancer is important for several reasons:

*It helps the doctor plan the best and most effective treatment for your cancer.

*It also helps identify if you are elgible for certain clinical trials of new drugs and therapies.

*And lastly, it helps estimate your prognosis or chance of recovery.

Simply put, staging the cancer is a good way of describing the cancer, where it's located and if it has spread to other organs in the body. Pancreatic Cancer Stages are generally based on the knowledge of how this particular cancer progresses or spreads.

The most common way of staging cancer is to use a numerical system called TNM classification. It assigns numbers to each progression of the cancer. If we were to use this system with pancreatic cancer, it would go something like this:

Stage 0: The tumor is confined to the pancreas, only invading the top layers and not the deeper tissues. It has not spread outside of the pancreas.

Stage I: The tumor is confined to the pancreas. It has not spread to nearby lymph nodes or distant sites.

Stage II: The tumor is growing outside the pancreas but not into large blood vessels. It may or may not have spread to nearby lymph nodes but has not yet spread to distant sites.

Stage III: The tumor is growing outside the pancreas into nearby large blood vessels or major nerves. It may or may not have spread to nearby lymph nodes. It still has not spread to distant sites.

Stage IV: The cancer has spread to distant sites.

However, most doctors don't stage pancreatic cancer this way. They usually divide it into the following 3 categories:

Resectable:

At this stage of cancer, the tumor can be surgically removed or resected. The tumor may only be in the pancreas or just beyond it, but it has not grown into the important arteries and veins yet. There is usually no evidence of the cancer spreading to distant parts of the body at this stage.

Locally advanced (unresectable):

This stage is still only in and just around the pancreas, but it cannot be surgically removed because the tumor has now grown into nearby arteries or veins and may have spread to nearby organs. Since the cancer cannot be removed entirely by surgery, it is called unresectable. For these tumors, surgery would only be done to relieve symptoms or problems like a blocked bile duct or intestinal tract.

Metastatic:

This is the stage when the cancer has spread beyond the pancreas to other organs and distant areas of the body. Surgery may still be done, but the goal would be to relieve symptoms, not to cure the cancer.

We finally had a handle on mom's pancreatic cancer stage. She is considered locally advanced or unresectable because the tumor is growing around the portal vein. The doctor said it was impossible to remove the tumor without endangering her life.

That makes her cancer inoperable. And that stinks. We had high hopes when we heard that the cancer was still confined to the pancreas. Surgery seemed the solution. Then our hopes were dashed when the doctors (we went for a second opinion, which was the same as the first) said that surgery wasn't an option.

So, we're back to the question. You have pancreatic cancer. Now what?

Well, your doctor stages the cancer and then comes up with a plan.

And you take that plan, along with the tears, the prayers, the shock, and the panic, and throw in an abundance of love, support and encouragement.

And you take the next step. 

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