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20

NCCN Guidelines for Patients

®

:

Pancreatic Cancer, Version 1.2017

2

Treatment planning

Review

In this system, doctors classify pancreatic cancer into

four main groups: resectable, borderline resectable,

locally advanced unresectable, and metastatic.

Because this is the system most NCCN doctors use,

recommendations in the treatment guides in Part

5 are based on this system and its four groups of

pancreatic cancer:

†

†

Resectable cancer has not spread outside the

pancreas and appears to be easily treated with

surgery.

†

†

Borderline resectable cancer is confined to the

pancreas but approaches nearby structures or

severe symptoms are present, raising concern

that the cancer might not be resectable with

clear margins.

†

†

Locally advanced unresectable cancer has

spread outside the pancreas to nearby blood

vessels or other tissues and cannot be treated

with surgery.

†

†

Metastatic cancer has spread outside the

pancreas to organs and tissues far away in the

body.

Performance status

Your state of general health will be rated using a

performance status scale. The PS (

p

erformance

s

tatus) indicates a person’s general level of fitness.

A commonly used scale is the ECOG (

E

astern

C

ooperative

O

ncology

G

roup) Performance Scale

with scores ranging from 0-4.

Zero means you are fully active, 1 means you are still

able to perform light to moderate activity, 2 means

you can still care for yourself but are not active, 3

means you are limited to the chair or bed more than

half of the time, and 4 means you need someone

to care for you and are fully limited to a chair or

bed. This score helps doctors decide what kind of

treatment is most suitable for you.

Patients with a PS of 3 or 4 are often recommended

to receive supportive, or palliative, care

rather than

aggressive cancer treatment. See Part 4 for more

information on supportive care.

Review

†

†

Cancer tests are used to find cancer, plan

treatment, and check how well treatment is

working.

†

†

Your health history and a body exam inform

your doctor about your health.

†

†

Blood tests check for signs of disease.

†

†

Tests that take pictures of the inside of your

body may show cancer.

†

†

Tests of tissue or fluid removed from your body

may find cancer.

†

†

The cancer stage is a rating by your doctors of

how far the cancer has grown and spread.

†

†

The PS (

p

erformance

s

tatus) indicates a

person’s general level of fitness.