Understanding Your Stage of Pancreatic Cancer

Stage is the word doctors use to communicate the size of a cancerous tumor and where and how far it has spread. The first place cancer is found in the body is called the primary site or primary tumor. When a cancer spreads, it’s said to have metastasized.

The TNM System

The TNM System is a standard way of describing the extent of a cancer’s growth. It is the most common system used to stage pancreatic cancer. It was developed by the International Union Against Cancer and the American Joint Committee on Cancer (AJCC). Here is what the letters stand for in the TNM System.

• T refers to the size of the tumor in the pancreas and nearby areas.

• N refers to whether any lymph nodes in the area of the pancreas have become cancerous.

• M refers to whether the cancer has spread to other, distant organs in the body (metastasized), such as your bones, liver, or lungs.

Stage Groupings of Pancreatic Cancer

The AJCC TNM classification defines cancers by Roman numbers 0 through IV. Your oncologist assigns numerical values from X to 4 to your T, and 0 or 1 to your N and M stages. These letter and number combinations are called stage groupings. Doctors use them to determine your overall disease stage. The lower the number, the less the cancer has spread. The higher the number, the more the cancer has spread. These are the stages of pancreatic cancer and their definitions. Be sure to ask your doctor to help explain your cancer’s stage to you. Each TNM category falls into one of these stages. An ‘X’ means that the T, N, or M cannot be determined.

StageI. Cancer is only found in the pancreas. The cancer has not spread to the lymph nodes.

Stage II. The cancer has spread to other areas near the pancreas, including lymph nodes. The cancer may have spread to the duodenum, the bile duct, or tissue around the pancreas.

Stage III. The tumor has spread to major blood vessels.  

Stage IV. The cancer has moved to organs further away from the pancreas. This might include the liver, lining of the abdomen (called the peritoneum), lungs, brain, or bones.

Doctors refer to stages I and II as early-stage pancreatic cancer. Doctors call stages III and IV advanced pancreatic cancer.