What is stage II pancreatic cancer?

Pancreatic cancer is often staged using the TNM system of cancer staging, in which T represents tumour, N for node, and M stands for metastasis. Tumour indicates the size of the initial tumour, Node indicates the presence of cancer in lymph nodes, and Metastasis indicates cancer spreading from the source tissue to other tissues and organs.

The second stage of pancreatic cancer is resectable or borderline resectable cancer, which occurs when the cancer has only progressed to the blood vessels but is still operable.

Treatment options:

The type of treatment offered to the patient is determined by the stage of cancer, the tumor's spread, the tumor's location, the patient's tolerance level, and overall health.

Surgical excision of tumours for resectable cancer and surgery combined with additional therapy for borderline resectable disease are options for stage II pancreatic cancer. These treatments try to reduce the cancer's size or shift it away from blood cells, making surgical removal easier.

Surgery

If the cancer has not gone beyond the pancreas, surgical methods are utilised to remove the tumour and adjacent lymph nodes. However, because of the pancreas' position, surgery to treat pancreatic tumours might be difficult.

The bile duct is usually shifted to the centre of the small intestine, and only a few times is the bile duct left open with a stent. The pancreaticoduodenectomy (Whipple technique) is the most common surgery performed to treat stage II pancreatic cancer. It involves cutting the final part of the stomach and attaching it to the middle of the small intestine, redirecting the bile duct into the jejunum.

Neoadjuvant therapy or pre-operative therapy:

Patients with borderline resectable pancreatic cancer are given neoadjuvant therapy or pre-operative therapy before surgery. Its goal is to reduce the tumour so that it can be surgically removed with clear margins. Chemotherapy, with or without radiation, is usually used as part of the treatment.

  • Chemotherapy is a type of treatment that involves the use of chemicals to destroy cancer cells and shrink the tumour.
  • Radiotherapy is a treatment that involves delivering high doses of x-rays to the tumour in order to shrink it.
  • Chemoradiation is a treatment that combines chemotherapy with radiation therapy. It's given before surgery to shrink the malignancy and limit the chances of it returning.

Adjuvant therapy

Adjuvant therapy, often known as post-operative therapy, is used after surgery. Treatment normally begins within 8-12 weeks after surgery, depending on the cancer's recurrence and the patient's recuperation.

Chemotherapy and radiotherapy may be used again in this treatment.

  • Chemotherapy is used for about 6 months after surgery. Gemcitabine and capecitabine are taken together to achieve the best results.
  • Radiotherapy: When there are no clear margins after surgery, radiation may be provided depending on the patient's recuperation.

Survival rates:

The general 5-year survival rate for stage II pancreatic cancer is roughly 5 to 7%, whereas it is about 52 percent for those who are resectable.

Because tumour excision eliminates cancer and reduces the odds of recurrence, resectable pancreatic malignancies have a good survival rate. Surgery alone has a 5-year survival rate of 10-35 percent for stage II pancreatic cancer.

The survival rate of borderline resectable malignancies is entirely dependent on the treatment offered, the cancer's progress, and the patient's tolerance. Chemotherapy and/or radiation at higher doses make surgical procedures easier, resulting in higher survival rates.