TNM staging for pancreatic cancer

TNM stands for Tumour, Node, and Metastasis. It's one of the staging systems for pancreatic cancer. Doctors may also use the number staging system.

The stage of a cancer tells the doctor about its size and whether it has spread. It helps your doctor decide on the best treatment for you.

The tests and scans you have when diagnosing your cancer give some information about the stage. But your doctor may not be able to tell you the exact stage of your cancer until after your surgery, if you are able to have it.

Tumour (T)

Tumour (T) describes the size and depth of the tumour (area of cancer).

Tis (carcinoma in situ) is very early stage pancreatic cancer. It hasn't grown into the deeper layers of tissue within the pancreas. It is uncommon for pancreatic cancer to be diagnosed this early.

T1 means the cancer is inside the pancreas and is 2cm or less in any direction.

T1 is split into 3 stages:

• T1a means the cancer is no more than 0.5cm 
• T1b means the cancer is more than 0.5cm but less than 1cm
• T1c means the cancer is between 1cm and 2cm

T2 means the cancer is between 2cm and 4cm in any direction.

T3 means the cancer is bigger than 4cm but is still within the pancreas.

T4 means the cancer has grown outside the pancreas, into the nearby large blood vessels.

Node (N)

Node (N) describes whether the cancer has spread to the lymph nodes.

N0 means there are no cancer cells in the nearby lymph nodes.

N1 means there are 1 to 3 lymph nodes that contain cancer cells.

N2 means that there is cancer in 4 or more lymph nodes.

Cancer that has spread to the nearby lymph nodes means there is a higher risk that cancer cells may have spread further than the pancreas.

Metastasis (M)

Metastasis (M) describes whether the cancer has spread to a different part of the body.

M0 means the cancer has not spread to other areas of the body such as the liver or lungs.

M1 means the cancer has spread to other areas of the body.

Treatment

The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:

• your type of pancreatic cancer
• where the cancer is
• if they can remove (resect) the cancer
• your general health and level of fitness

The stage of the cancer and these other factors can also give an idea of your outlook (prognosis).