After diagnostic tests the cancer will be assigned a stage to describe how far it has spread. The most common staging system used for pancreatic cancer is the TNM system. In this system letters are assigned numbers to describe the cancer.
T (Tumour) 1–4 indicates the size and depth of tumour invasion into the pancreas and nearby tissues.
|T1||the tumour and has not spread beyond the pancreas and is small|
|T2||the cancer has not spread beyond the pancreas but is larger than two centimetres across|
|T3||the tumour has spread from the pancreas into the surrounding tissues but not to major blood vessels or nerves|
|T4||is a larger tumour that has invaded the major blood vessels or nerves nearby.|
N (Nodes) 0–1shows if the cancer has spread to nearby lymph nodes
|N0||means that the cancer has not spread to the lymph nodes|
|N1||means there is cancer in the local lymph nodes|
M (Metastasis) 0–1 shows if the cancer has spread to other parts of the body.
|M0||means that the cancer has not spread|
|M1||means that the cancer has spread away from the area around the pancreas to more distant parts of the body (e.g. the liver)|
Your doctor may also just use numbers to describe the stage:
Stage 1 - cancer is found only in the pancreas and has not spread to any organs or lymph nodes next to 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 small bowel or common bile duct), or is large but has not spread to neighbouring organs
Stage 3 - cancer has grown into nearby major arteries. There may or may not be cancer in the lymph nodes
Stage 4 - the cancer has spread to other organs, such as the liver, lungs or lining of the abdomen
Ask your doctor to explain the stage in a way you can understand. This will help you to choose the best treatment for your situation.
Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis with your doctor but it is not possible for any doctor to predict the exact course of your disease.
Your prognosis will depend on the stage of the cancer, the location of the tumour and other factors such as your age, fitness and medical history.
In general the sooner cancer is diagnosed, the better the prognosis.
This is because the cancer may not have spread beyond the pancreas and treatment can start earlier. However pancreatic cancers –especially exocrine tumours – are usually not found until they are advanced because symptoms can be vague or go unnoticed.
For people who have PNETs, functioning tumours may have better outcomes than non-functioning tumours.
Advanced cancer is more difficult to treat successfully but palliative treatment can relieve various symptoms and help to improve quality of life.