Stage 2 Pancreatic Cancer

What is stage 2 pancreatic cancer?

Pancreatic cancer is one of the deadliest forms of cancer that affects more than 62,210 Americans, accounting for 3% of all cancers. Moreover, Pancreatic cancer is the tenth most common cancer in men and eighth in women [¹]. In stage 2 cancer, the cancer has spread beyond the pancreas but is still localized in the immediate area. The cancer may have spread to nearby lymph nodes or blood vessels but has not yet spread to other body parts.

What are the substages of stage 2 pancreatic cancer?

The second stage of pancreatic cancer is further divided into substages based on the tumor's size and location.

Stage 2A Pancreatic Cancer

In stage 2A pancreatic cancer, the tumor is limited to the pancreas and measures less than four centimeters. The cancer has not yet spread to nearby lymph nodes or distant organs and blood vessels.

Stage 2B Pancreatic Cancer

In stage 2B pancreatic cancer, the tumor has grown larger than four centimeters and may have spread to nearby lymph nodes or blood vessels. The cancer has not yet spread to other organs. Stage 2B pancreatic cancer is more advanced than stage 2A, and the prognosis is generally worse.

The substages of stage 2 pancreatic cancer have important implications for treatment and prognosis. The specific treatment plan will depend on the location and size of the tumor, as well as the stage and substages of the cancer.

Stage 2A pancreatic cancer is generally more treatable than stage 2B, and the prognosis is generally better. Stage 2A pancreatic cancer may be treated with surgery, while stage 2B pancreatic cancer may require chemo and radiation at the same time.

It's important to note that every case of pancreatic cancer is unique, and treatment plans and prognoses may vary. It's important to work closely with a healthcare team to determine the best course of treatment for your case.

Stage 2 pancreatic cancer staging and diagnosis

Pancreatic Cancer Staging

Pancreatic cancer is divided into four main stages based on the progression level of the cancer. In general, the TNM system is used to describe and classify cancer and is managed by The American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC) [²].

T (tumor) describes the size and location of the tumor and can either be TX (no information), T0 (no evidence), Tis (the pre-cancer stage where cancer is growing in the tissue it was found), and any number between one to four after the T (The higher the number, the bigger the tumor or, the more it has spread).
N (nodes) indicates whether it has spread to nearby lymph nodes and can either be NX (no information about nearby lymph nodes), N0 (no cancer in nearby lymph nodes), or any number between one to four after N (the higher the number, the bigger the tumor or, the more it has spread to nearby lymph nodes).
M (metastasis) describes if and how far the cancer has spread from its origin and can either be M0 (the cancer did not spread) or M1 )the cancer has spread to distant organs.

How Common is stage 2 pancreatic cancer?

According to the American Cancer Society, pancreatic cancer accounts for around 3% of all cancers and 7% of all cancer deaths in the United States. Moreover, around 64000 people will be diagnosed with pancreatic cancer, and 50,000 will die in 2023. The average risk of pancreatic cancer is one in 64 people [³]. 90% of patients diagnosed have stage 2 pancreatic cancer [⁴].

How is stage 2 pancreatic cancer diagnosed?

If your doctor suspects pancreatic cancer, they will likely recommend a series of tests to confirm the diagnosis. These may include:

Blood tests: Blood tests can help detect substances produced by pancreatic cancer cells, such as CA 19-9 [⁵].
Imaging tests: Imaging tests such as CT scans, MRI, or PET scans can help identify the location and extent of the cancer. These tests may also determine if the cancer has spread to nearby lymph nodes or other organs [⁶].
Endoscopic ultrasound: This test involves the insertion of a small, flexible tube with an ultrasound probe into the stomach to obtain images of the pancreas and surrounding tissues. This can help identify the size and location of the tumor [⁷].
Biopsy: A biopsy involves the removal of a small sample of tissue from the pancreas for analysis. This can help confirm the diagnosis of pancreatic cancer and provide information about the stage of the disease [⁸].

Stage 2 pancreatic cancer symptoms

The symptoms of pancreatic cancer can vary depending on the stage of the disease. Stage 2 cancer symptoms may include:

Abdominal pain
Jaundice (yellowing of the skin and eyes)
Unexplained weight loss
Loss of appetite
Nausea and vomiting
Fatigue

Various conditions can cause these symptoms, so it's important to consult a doctor if you experience any of these symptoms.

Stage 2 pancreatic cancer primary/first-line treatment

The primary treatment for stage 2 pancreatic cancer is surgery, which aims to remove the cancerous tumor and any surrounding tissue that may be affected.

The type of surgery performed for stage 2 pancreatic cancer is called a pancreaticoduodenectomy, or Whipple procedure. During this procedure, the head of the pancreas, the first part of the small intestine, the gallbladder, and sometimes part of the stomach are removed. The remaining parts of the pancreas and small intestine are then connected so digestive enzymes and bile can still flow into the small intestine [⁹].

After surgery, chemotherapy may be recommended to help kill any remaining cancer cells and reduce the risk of recurrence. Radiation therapy may help with the treatment for tumor size before surgery or kill any remaining cancer cells after surgery [¹⁰].

In some cases, neoadjuvant therapy may be recommended before surgery. This involves receiving chemotherapy and/or radiation therapy before surgery to shrink the tumor and make it easier to remove it [¹¹].

It's important to note that treatment plans for stage 2 pancreatic cancer may vary depending on the individual case and the patient's overall health. Treatment decisions should be made in consultation with a healthcare team, including a medical oncologist, a radiation oncologist, and a surgeon.

Other Types of treatment for stage 2 pancreatic cancer

Current treatment options available for stage 2 pancreatic cancer include:

1. Chemotherapy

Chemotherapy is often used in combination with surgery for stage 2 pancreatic cancer. Chemotherapy drugs are used to kill cancer cells that may remain after surgery and any cancer cells that may have spread to nearby lymph nodes or other organs.

2. Radiation Therapy

Radiation therapy uses high-energy X-rays to kill cancer cells. Doctors sometimes recommend chemo and radiation at the same time to treat stage 2 pancreatic cancer. Radiation therapy can be administered externally or internally, depending on the case.

3. Immunotherapy

Immunotherapy is a relatively new treatment option for pancreatic cancer. It boosts the body's immune system to help it recognize and attack cancer cells [12]. Immunotherapy drugs are given intravenously, and they can help slow the growth of cancer cells.

4. Clinical Trials

Clinical trials test new treatments or treatment combinations for pancreatic cancer. Patients with stage 2 pancreatic cancer may be eligible to participate in clinical trials, which can offer new treatment options not yet available to the general public.

Is stage 2 cancer curable?

The outlook for grade 2 cancer of the pancreas depends on various factors, including the size and location of the tumor, whether the cancer has spread to the lymph nodes or other nearby tissues, and the patient's overall health. While stage two cancer is among the list of curable cancers, the treatment success rate can vary widely.

Surgery is often the primary treatment for stage 2 pancreatic cancer and can be curative in some cases. The Whipple procedure, or pancreaticoduodenectomy, involves removing the head of the pancreas, part of the small intestine, the gallbladder, and sometimes part of the stomach. The remaining parts of the pancreas and small intestine are then connected, allowing the proper flow of digestive enzymes and bile. If the surgery successfully removes all the cancer, and there is no evidence of residual disease, the patient may be considered cured.

However, even after surgery, there is a risk that cancer may recur. For this reason, patients who undergo surgery for stage 2 pancreatic cancer often receive additional treatment, such as chemo and radiation therapy, to help kill any remaining cancer cells and reduce the risk of recurrence, helping improve stage 2 cancer life expectancy.

In some cases, neoadjuvant therapy, which involves receiving chemotherapy and/or radiation therapy before surgery, may be recommended to shrink the tumor and make it easier to remove. This approach can increase the chances of a successful surgery and improve the overall outcome.

Prognosis: Stage 2 pancreatic cancer survival rate

Stage 2 cancer survival rate

According to the National Cancer Institute, the pancreatic cancer stage 2 survival rate is 14.7%, while the overall cancer survival rate is around 11% for the first five years after diagnosis. This means that 14 patients out of 100 will survive the first five years after diagnosis of stage two cancer [¹³].

It is important to note that survival rates are statistical averages and cannot predict how long any individual with pancreatic cancer will survive. Each person's case is unique, and the best way to determine their prognosis is to consult with a medical professional who can evaluate their case and provide personalized information.

Stage 2 pancreatic cancer recurrence rate

Research shows that even with treatment, there is a high chance of pancreatic cancer recurrence (around 80%) within the first five years of treatment and over 60% in the first two years [¹⁴].

Stage 2 pancreatic cancer growth rate

The growth rate of stage 2 pancreatic cancer can vary depending on several factors, such as the size of tumors, tumor grade, location, aggressiveness, the level of treatment, the individual's overall health, and other medical conditions. Therefore, it is difficult to provide a definitive answer.

Pancreatic cancer is notorious for its aggressive nature and can grow and spread rapidly. However, it can be challenging to predict the growth rate of a specific pancreatic tumor accurately, as it might vary significantly from individual to individual.

Lifestyle changes for preventing and managing stage 2 pancreatic cancer

Even though a few risk factors for pancreatic cancer, including age and family history, cannot be altered, you can adopt many lifestyle changes that might help decrease the risk of developing this cancer and improve disease management. So, let’s explore some lifestyle changes that might help prevent and manage pancreatic cancer.

1. Quit Smoking

Smoking is a significant risk factor for pancreatic cancer. According to the American Cancer Society, smoking increases the chances of developing pancreatic cancer by two to three times, and 25% of pancreatic cancers are caused by tobacco smoking [¹⁵]. Quitting smoking can help reduce the risk of pancreatic cancer and other health problems.

2. Maintain a Healthy Weight

Obesity has been linked to an increased risk of developing pancreatic cancer [¹⁶]. Maintaining a healthy weight through diet and exercise may help reduce the risk of pancreatic cancer. Eating a healthy, balanced diet rich in fruits, vegetables, whole grains, and lean protein sources can also help you maintain a healthy weight and reduce cancer risk.

3. Exercise Regularly

Regular physical activity can help reduce the risk of pancreatic cancer [¹⁷]. Exercise can also help improve overall health and reduce the risk of other health problems, such as heart disease and diabetes. Aim for at least two hours of moderate weakly exercise, such as brisk walking or cycling.

4. Limit Alcohol Consumption

Drinking alcohol in moderation is generally considered safe for most people. However, heavy alcohol consumption has been linked to an increased risk of pancreatic cancer [¹⁸]. Limiting alcohol consumption to no more than one drink per day for women and two drinks per day for men may help reduce the risk of pancreatic cancer.

5. Get Regular Screenings

Regular screenings may help detect pancreatic cancer early when it is more treatable. If you are at high risk of developing pancreatic cancer, such as a family history of the disease, your doctor may recommend regular screenings, such as imaging or blood tests.

6. Manage Chronic Conditions

Chronic conditions, such as diabetes and pancreatitis, have been linked to an increased risk of pancreatic cancer [¹⁹]. Managing these conditions through lifestyle changes and medication may help reduce the risk of pancreatic cancer and improve the management of the disease.

Conclusion

Takeaway

stage 2 pancreatic cancer is a serious condition that requires prompt medical attention. If you experience any symptoms of pancreatic cancer, it's important to consult with a doctor immediately. Early detection and treatment can improve your chances of a positive outcome. If you or someone you know has been diagnosed with stage 2 pancreatic cancer, talk to your doctor about the best treatment options for your case.