Staging

If cancer of the pancreas is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment.

Staging is a careful attempt to find out the following:

• The size of the tumor in the pancreas
• Whether the tumor has invaded nearby tissues
• Whether the cancer has spread, and if so, to what parts of the body

When cancer of the pancreas spreads, the cancer cells may be found in nearby lymph nodes or the liver. Cancer cells may also be found in the lungs or in fluid collected from the abdomen.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original (primary) tumor. For example, if pancreatic cancer spreads to the liver, the cancer cells in the liver are actually pancreatic cancer cells. The disease is metastatic pancreatic cancer, not liver cancer. It’s treated as pancreatic cancer, not as liver cancer. Doctors sometimes call the new tumor in the liver “distant” disease.

To learn whether pancreatic cancer has spread, your doctor may order CT scans or EUS.

Also, a surgeon may look inside your abdomen with a laparoscope (a thin, tube-like device that has a light and a lens for seeing inside the body). The surgeon inserts the laparoscope through a small incision in your belly button. The surgeon will look for any signs of cancer inside your abdomen. You’ll need general anesthesia for this exam.

These are the stages of cancer of the pancreas:

• Stage I: The tumor is found only in the pancreas.
• Stage II: The tumor has invaded nearby tissue but not nearby blood vessels. The cancer may have spread to the lymph nodes.
• Stage III: The tumor has invaded nearby blood vessels.
• Stage IV: The cancer has spread to a distant organ, such as the liver or lungs.