What Are the Stages of Pancreatic Cancer?

Pancreatic cancer is one of the most challenging cancers to diagnose and treat, but understanding its staging is crucial for patients and their families as they navigate the journey from diagnosis to treatment. At Dmitri Alden, MD, FACS, in New York City, we believe that patient education and compassionate, expert care are the foundation for the best possible outcomes.

Pancreatic Cancer Facts

Pancreatic cancer accounts for about 3% of all cancers in the United States but causes about 7% of all cancer deaths. According to the American Cancer Society, over 64,000 Americans were diagnosed with pancreatic cancer in 2024.

Unfortunately, because symptoms often don’t appear until the disease is advanced, pancreatic cancer is frequently diagnosed at a later stage. The five-year survival rate remains low (about 13%), but early diagnosis and cutting-edge surgical interventions can improve outcomes for many patients.

How Is Pancreatic Cancer Diagnosed?

According to the Pancreatic Cancer Action Network, diagnosing pancreatic cancer often begins with an evaluation of symptoms such as abdominal pain, jaundice (yellowing of the skin and eyes), unexplained weight loss and digestive issues. Because these symptoms can be vague, a thorough diagnostic process is essential:

• Imaging Tests: CT scans, MRI, endoscopic ultrasound (EUS) and PET scans can help identify tumors and determine their size and location.
• Blood Tests: Markers like CA 19-9 may be elevated in pancreatic cancer.
• Biopsy: Tissue samples, often obtained via EUS-guided fine needle aspiration, confirm the diagnosis.

Once pancreatic cancer is confirmed, staging helps determine the extent of the disease and guides treatment planning.

What Are the Stages of Pancreatic Cancer?

The American Cancer Society® stages pancreatic cancer based on the tumor’s size, location, involvement with nearby blood vessels and whether it has spread (metastasized) to lymph nodes or distant organs. The most commonly used staging system is the American Joint Committee on Cancer (AJCC) TNM system, which considers:

• T (Tumor): Size and extent of the main tumor
• N (Nodes): Spread to nearby lymph nodes
• M (Metastasis): Spread to distant organs

Stage 0: Carcinoma in Situ

• Definition: Abnormal cells are found in the lining of the pancreas, but have not spread outside this layer.
• Significance: Considered non-invasive and highly treatable if detected at this stage.

Stage I: Localized Disease

• Stage IA: Tumor is confined to the pancreas and 2 cm or smaller.
• Stage IB: Tumor is confined to the pancreas and larger than 2 cm but not more than 4 cm.
• No lymph node involvement or distant spread.

Stage II: Locally Advanced Disease

• Stage IIA: Tumor is larger than 4 cm, still limited to the pancreas, no lymph node involvement.
• Stage IIB: Tumor can be any size, but cancer has spread to 1-3 nearby lymph nodes, not to distant sites.

Stage III: Locally Advanced with Major Vessel Involvement

• Definition: Tumor may involve major blood vessels near the pancreas and/or more lymph nodes (4 or more).
• No distant metastasis.

Stage IV: Metastatic Disease

• Definition: Cancer has spread to distant organs such as the liver, lungs or peritoneum.
• Most advanced stage, often not curable, but treatment can help manage symptoms and improve quality of life.

Why Is Staging Important?

Staging determines the treatment approach:

1. Early Stages (0, I): Surgery is often possible and may offer a chance for cure, sometimes combined with chemotherapy or radiation.
2. Stage II: Surgery may still be an option, depending on the tumor’s relationship to blood vessels, often combined with chemotherapy and/or radiation.
3. Stage III: Surgery is typically not possible, but chemotherapy and radiation may help shrink the tumor or control symptoms. In select cases, advanced surgical techniques may be considered.
4. Stage IV: Focus is on controlling symptoms, prolonging survival and improving quality of life through chemotherapy, targeted therapy and supportive care.

Why Patients Trust Dmitri Alden, MD, FACS

Dr. Dmitri Alden is a board-certified, fellowship-trained surgical oncologist and hepatopancreatobiliary (HPB) surgeon with decades of experience treating pancreatic cancer. With a reputation for tackling highly complex cases and employing the most advanced surgical and minimally invasive techniques, Dr. Alden is a leading choice for pancreatic cancer care in NYC. Patients choose Dr. Alden for his:

• Expertise in complex and minimally invasive pancreatic surgery
• Comprehensive, multidisciplinary approach
• Personalized care and compassion
• Track record of excellent outcomes, even in challenging cases

Whether you need a second opinion, advanced surgical options or guidance through every step of your cancer journey, Dr. Alden and his team are dedicated to providing world-class care.

5 Pancreatic Cancer FAQs

What are the common symptoms of pancreatic cancer?

Symptoms may include abdominal pain, jaundice, weight loss, loss of appetite and changes in stool. Unfortunately, symptoms often appear late.

Can pancreatic cancer be cured?

A cure is possible if the cancer is detected at an early stage and completely removed surgically. For advanced stages, treatment can extend life and improve quality of life.

What are the main risk factors for pancreatic cancer?

Risk factors include smoking, family history, chronic pancreatitis, diabetes, obesity and certain genetic conditions.

How is pancreatic cancer treated?

Treatment options may include surgery, chemotherapy, radiation, targeted therapy or a combination. The treatment plan depends on the stage and overall health of the patient.

Why should I seek care from a specialized pancreatic cancer surgeon?

Pancreatic cancer surgery is highly complex and best performed by a specialized, experienced HPB surgeon for optimal outcomes and lower complication rates.

Take the Next Step with Dmitri Alden, MD, FACS

If you or a loved one has been diagnosed with pancreatic cancer or needs expert evaluation, trust your care to one of New York City’s most experienced pancreatic cancer surgeons. Contact Dmitri Alden, MD, FACS, today to schedule a consultation and discuss your treatment options in a compassionate, patient-focused environment.