Pancreatic cancer is staged according to Roman numerals IA to IV. Pancreatic cancer that is labeled as stage IA includes those that are confined to the pancreas and that are less than 2 cm in size. Stage IB pancreatic cancers are larger than 2 cm in size, but they are still confined to the pancreas and have not yet spread to the lymph nodes or other parts of the body. If a pancreatic cancer is labeled stage IIA, it means that the cancer has grown outside the pancreas, but it has not spread to the lymph nodes or large blood vessels and with stage IIB, the cancer has spread to the lymph nodes, but not to the large blood vessels. With stage III pancreatic cancer, the cancer has spread to the large blood vessels and may have spread to the lymph nodes, but it has not spread to distant parts of the body. Stage IV pancreatic cancer is the most severe and in these instances, the cancer has spread to distant parts of the body.
Because pancreatic cancer cannot be accurately staged until surgery is performed, most doctors will use generalized staging prior to performing surgery. This staging system is not based on how far the cancer has spread, but on how confident the doctor is that he or she can remove all of the cancer during surgery. These stages are referred to as resectable, locally advanced and metastatic.
If a doctor stages a cancer as resectable, it means that he or she believes that all of the cancer can be successfully removed during surgery. Resectable pancreatic cancer is treated surgically, either by a pancreaticoduodenectomy or by total pancreatectomy. The patient will also usually be given chemotherapy and radiation therapy in addition to surgery. The chemotherapy and radiation therapy will usually be given prior to surgery due to the fact that recovery from surgery may delay the onset of these therapies.
If the cancer is labeled as locally advanced, it means that the cancer cannot be entirely removed by surgery, though it has not spread to distant parts of the body. Locally advanced cancer is usually treated with chemotherapy and radiation therapy. In some circumstances, the chemotherapy and radiation treatments may reduce the cancer enough so that it becomes resectable and the cancer can then be removed surgically.
If the pancreatic cancer is labeled as metastatic, it means that it cannot be removed with surgery and that it has spread to the body¡¯s distant organs. Chemotherapy is usually the only viable treatment option for patients whose cancer falls within this category. Some patients with metastatic pancreatic cancer may choose to participate in clinical trials in hopes of finding a more effective treatment method. Some metastatic pancreatic cancer patients do undergo surgery, but not with the intention of having the cancer removed. In these instances, surgery is usually performed in order to reduce the symptoms caused by the advanced cancer.
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