Pancreatic cancer can be categorized into several stages, which are used to define how far the cancer has spread throughout the body, and to determine the best possible form of treatment. Since pancreatic cancer can spread at such a rapid pace, an early diagnosis is necessary to prevent it from reaching a more advanced stage where treatment options are limited. According to Mayo Clinic, pancreatic cancer is one of the leading causes of cancer deaths due to how fast it can spread and because it is difficult to detect at an early stage since its symptoms often do not occur until the disease is far advanced.
Stages of Pancreatic Cancer
Pancreatic cancer stages are used to define how far the disease has spread, to help guide physicians in determining a suitable form of treatment, and to help with the classification of patients for clinical trials.
- Stage 0: This stage of pancreatic cancer is also known as carcinoma in situ and is used to define a single layer of abnormal cells found in the pancreas lining that may spread to normal tissues nearby. In this stage, pancreatic cancer is difficult to detect for it is not clearly visible in imaging tests.
- Stage I: This stage is used to define only a local growth of pancreatic cancer, meaning the cancer has only formed within the pancreas. This stage can be divided into two categories depending on the size of the tumor found. Tumors that are two centimeters and below or classified as "stage IA" and tumors larger than two centimeters are classified as "stage IB".
- Stage II: Pancreatic cancer that has spread to nearby tissues and organs, like the bile duct or duodenum, can be classified as stage II. This stage can also be divided into two categories, where "stage IIA" is defined as cancer that has not spread to the lymph nodes, but has spread to other organs or tissues. "Stage IIB" is used to define cancer that has spread to other organs, tissue and nearby lymph nodes.
- Stage III: Stage III pancreatic cancer defines a wide spread growth, where blood vessels near the pancreas become affected. At this stage, the lymph nodes and nearby nerves have most likely been affected, while distant organs have not.
- Stage IV: In stage IV pancreatic cancer, the disease is in its most advanced stage and has spread to nearby organs and distant organs, including the liver or lungs.
- Recurring pancreatic cancer: Although it is not an actual stage, recurring pancreatic cancer is another category of pancreatic cancer where the disease returns after it has already been treated. Recurring pancreatic cancer can appear in the pancreas or other areas of the body.
Types of Treatment
There are three main types of treatment for pancreatic cancer:
If the cancer is restricted to just the pancreas, surgery is a possible type of treatment for pancreatic cancer. Surgical procedures include:
- Whipple procedure: this procedure removes the head of the pancreas, the duodenum, the gallbladder and a portion of the bile duct. It is used when pancreatic cancer is found in the head of the pancreas.
- Distal pancreatectomy: this procedure removes the tail and/or body of the pancreas. The spleen may also be removed during a distal pancreatectomy.
- Total pancreatectomy: this procedure removes the entire pancreas.
- Palliative surgery: this type of surgery is performed when pancreatic cancer is in its advanced stages and cannot be removed surgically, but is used to alleviate symptoms. For example, gastric bypass is a form of palliative surgery used to allow food to be digested when a tumor obstructs the flow of food from the stomach.
Chemotherapy uses special drugs to eliminate cancer cells or to keep them from dividing. When these drugs are taken orally or through an injection, they pass through the blood stream to reach the cancer cells. When chemotherapy is performed in a direct area, like the abdomen, the drugs are localized to that specific area. This is known as regional chemotherapy.
Radiation therapy uses high-energy beams to eliminate cancer cells and to shrink tumors. There are two forms of radiation therapy:
- External radiation: a machine outside of the body directs the high-energy beams towards the cancer cells.
- Internal radiation: materials or fluids that create radiation are injected into the area of the body where cancer cells are located.
Treatment for Different Stages of Pancreatic Cancer
The physician may choose one or a combination of these treatment methods depending on the stage of the pancreatic cancer. Other factors that can affect the physician's choice in treatment are the patient's age, overall health and preferences.
- Stage I and II: surgery alone can be performed, or a combination of surgery, chemotherapy and radiation therapy.
- Stage III: the cancer cannot be surgically removed, but palliative surgery can be performed to relieve symptoms. Chemotherapy and radiation therapy may be used.
- Stage IV: palliative surgery is used to relieve symptoms and chemotherapy may be used.
- Recurring pancreatic cancer: chemotherapy, palliative surgery and palliative radiation therapy may be used.