Pancreatic cancer that has been diagnosed as Stage 2 (T1-3, N0-1, M0) may still be considered “resectable” since it has not yet spread to other parts of the body.
Typical treatment options for Stage 2 pancreatic cancer may include one or more of the following:
- Surgery
- The extent of surgery depends largely on the size of the tumor and where it is located on the pancreas. For cancer diagnosed as Stage 2, two procedures may be performed:
- Whipple Procedure
- Also called a pancreaticoduodenectomy, a whipple procedure is performed if the cancer is located on the widest part of the pancreas, also called the head. During this procedure, the surgeon removes this portion of the pancreas as well as part of the small intestine and stomach.
- Distal Pancreatectomy
- This type of surgery is performed when the tumor is located on the body and tail portions of the pancreas. The spleen is also removed during this type of surgery.
- Radiation Therapy
- This method, which uses high energy rays to kill the cancer cells, may be used before or after surgery to try to get rid of any cancerous cells that may remain in the area following surgery.
- Chemotherapy
- Studies have shown that giving chemotherapy after surgery may delay the recurrence of pancreatic cancer by approximately six months. Agents called gemcitabine and 5-FU are typically used to following surgery.
The TNM System for cancer staging
The stage of pancreatic cancer at diagnosis is typically determined by a staging system developed by the American Joint Committee on Cancer (AJCC) called the TNM System, which evaluates the tumor based on the following criteria:
- T Category
- Describes the size of the primary pancreatic tumor, which is measured in centimeters, and whether or not the cancer has spread throughout the pancrease
- N Category
- Whether or not the pancreatic cancer has spread to nearby lymph nodes
- M Category
- The absence or presence of distant metastasis
Since pancreatic cancer is hard to diagnosis, especially in the early stages, other terms are more often used to simplify the staging of this disease. These include:
- Resectable
- This means that the cancer is only in the pancreas and the entire tumor can be surgically removed.
- Unresectable or Locally Advanced
- These terms refer to the fact that the pancreatic cancer has not yet spread to other parts of the body, but the entire tumor cannot be surgically removed from the pancreas.
- Metastatic
- This term refers to the fact that the pancreatic cancer has spread to other organs. While surgery may be performed remove the tumor, it will likely only relieve symptoms rather that cure the cancer.
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