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Stages of Pancreatic Cancer

Natan Rosenfeld Natan Rosenfeld April 25, 2021
Medically reviewed by Susan Kerrigan, MD and Marianne Madsen

Pancreatic cancer is a type of cancer that affects the pancreas, an organ in your body that regulates blood sugar. Around 57,600 Americans are diagnosed with pancreatic cancer each year, and 47,000 will succumb to the disease.  Pancreatic cancer is particularly deadly since it is rarely diagnosed in its early stages. Early on, pancreatic cancer has no symptoms. When it does begin to cause symptoms, it usually means that the cancer is already at an advanced stage. 53% of people with pancreatic cancer are diagnosed at this point, where the survival rate is only 3%. The most common type of pancreatic cancer is adenocarcinoma of the pancreas. Less common types include neuroendocrine tumors of the pancreas and islet cell tumors which are much more rare, and tend to have a better prognosis.


The different stages of pancreatic cancer


As with all cancers, pancreatic cancer progresses in stages. Most doctors are in agreement that pancreatic cancer develops over a period of four different stages (though some say it develops over five stages), starting with the so-called “resectable” stage, moving on to the “borderline resectable” stage, then to the “locally advanced” stage, and finally, to the “metastatic” stage (where the cancer has spread to other parts of the body).


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Cancer - Terminology

Cancer - Terminology


10 to 15 percent of patients are diagnosed at this stage, where the cancer can still be removed through surgery. Since pancreatic cancer has such a low survival rate, it’s crucial to treat it as soon as it’s diagnosed. In this stage, the tumor remains in the pancreas and has not spread. 


Borderline resectable

At this stage, the tumor has grown but has not spread. It can still be removed but with difficulty and possible complications. If surgery is an option, chemotherapy or radiation therapy may need to be performed first to shrink the tumor. 


Locally advanced

35 to 40 percent of pancreatic cancer patients are diagnosed at this stage. Here, the cancer is still localized to the vicinity of the pancreas but has begun to spread to nearby areas. Surgery is no longer an option, since any sort of procedure may damage these areas. 



At the metastatic stage, the cancerous tumor has already spread to other organs in the body and cannot be removed or treated. 44 to 55 percent of patients are diagnosed at the metastatic stage.


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Cancer - Chemotherapy

Cancer - Chemotherapy

How can pancreatic cancer be treated?


As stated above, pancreatic cancer is not usually treatable when it’s diagnosed at a late stage. But if it’s detected early enough, the tumor may be removed or reduced with surgery, chemotherapy, or radiation therapy. Sometimes, it’s necessary to remove the entire pancreas, in an operation called a total pancreatectomy. In later stages of pancreatic cancer, treatment is redirected towards palliative care, which means relieving the patient’s symptoms and improving quality of life as long as possible. 


Other treatment options include clinical trials, which test experimental cancer drugs and therapies. Potential cancer treatments tested in such trials are not guaranteed to work and may come with severe side effects. However, if your pancreatic cancer has progressed to a late stage, it may be worth considering this option. Your doctor will inform you about all of your treatment options, and together, you can decide which one is right for you. 

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