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Stages of Pancreatic Cancer

I. Staging cancer is a standardized way to classify a tumor based on its size, whether it has spread, and where it has spread. In other words, staging measures the extent of the disease. Knowing the stage of cancer helps doctors determine which treatment options are the best approach. Most cancers are staged using the TNM system of classification, which was developed by the American Joint Committee on Cancer (AJCC).


II. The TNM system uses three factors to evaluate cancer: tumor, node, and metastasis:

• T stands for tumor and describes the size and location of the primary tumor, if and how far it has spread within the pancreas, and if it has spread to nearby structures.

• N stands for node and describes evidence of metastases in lymph nodes close to the pancreas, that is, whether or not the tumor has spread to the regional lymph nodes.

• M stands for metastasis and describes evidence of distant metastases, that is, whether or not the cancer has spread to distant parts of the body.

Combining T, N, and M defines the stage of cancer. Each patient’s condition is evaluated for T, N, and M, and the descriptions are combined to form a stage

  • Stage 0: Refers to cancer in situ, or the cancer has not invaded outside the ducts in which it originated.
  • Stage IA: The tumor in the pancreas is 2 cm or smaller and has not spread to lymph nodes or other parts of the body.
  • Stage IB: The tumor in the pancreas is larger than 2 cm and has not spread to lymph nodes or other parts of the body.
  • Stage IIA: The tumor extends beyond the pancreas but has not spread to nearby lymph nodes, major blood vessels, or other parts of the body.
  • Stage IIB: The tumor is any size and is either limited to or extends beyond the pancreas and has spread to lymph nodes but not to major blood vessels or other parts of the body.
  • Stage III: The tumor has spread to nearby blood vessels, may or may not have spread to nearby lymph nodes, but the cancer has not spread to other parts of the body.
  • Stage IV: The cancer has spread to other parts of the body.


III. Clinical classification is a simpler, more descriptive staging system for pancreatic cancer which is often used by doctors. This system divides cancers into groups based on whether or not the tumor can be removed surgically.

  • Resectable Cancer can be surgically removed. These tumors may lie within the pancreas or extend beyond it, but there is no involvement of the critical arteries or veins in the area. There is no evidence of any spread to areas outside of the tissue removed during a typical surgery for pancreatic cancer.
  • Stage 1 Pancreatic Cancer
    • Locally Advanced Cancer is confined to the area around the pancreas but cannot be surgically removed because the tumor may be intertwined with major blood vessels and may have invaded surrounding organs. No evidence of spread to other areas of the body can be found.
    • Locally Advanced Cancer


    • Metastatic Cancer has spread beyond the area of the pancreas and involves other organs, such as the liver or lungs, or other areas of the abdomen.
    • Metastatic Cancer



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