Pancreatic cancer staging and prognosis

TNM system

The most common staging system for pancreatic cancer is the TNM system. In this system, each letter is given a number that shows how advanced the cancer is. 

• T (Tumour) − Refers to the size of the tumour (T0−4). The higher the number, the larger the cancer.
• N (Nodes) − N0 means there is no spread to nearby lymph nodes; N1 means there is cancer in nearby lymph nodes.
• M (Metastasis) − M0 means the cancer has not spread to other parts of the body; M1 means it has.

Numbers

Your doctor may just use an overall number to describe the stage.

• Stage 1 − Cancer is found only in the pancreas. This is sometimes called early-stage disease.
• Stage 2 − Cancer has either spread to lymph nodes or structures near the pancreas (such as the duodenum or common bile duct), or is large but has not spread to nearby organs.
• Stage 3 − Cancer has grown into nearby major arteries. There may or may not be cancer in the lymph nodes. This is called locally advanced cancer.
• Stage 4 − The cancer has spread to other organs, such as the liver, lungs or lining of the abdomen. This is known as metastatic cancer.

Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis with your doctor, but it is not possible for anyone to predict the exact course of the disease.

To work out your prognosis, your doctor will consider:

• test results
• the type, stage and location of the cancer
• how the cancer responds to initial treatment
• your medical history
• your age and general health.

As symptoms can be vague or go unnoticed, most pancreatic cancers are not found until they are advanced. Cancer that has spread to nearby organs or blood vessels (locally advanced) or other parts of the body (metastatic) is difficult to treat successfully. If the cancer is detected at an early stage and can be surgically removed, the prognosis may be better.

It is important to know that although the statistics for pancreatic cancer can be frightening, they are an average and may not apply to your individual situation, so talk to your doctor about how to interpret any statistics that you come across.

When pancreatic cancer is advanced, treatment will usually aim to control the cancer for as long as possible, relieve symptoms and improve quality of life. This is known as palliative treatment.