NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2017
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
Resectable cancer has not spread outside the
pancreas and appears to be easily treated with
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
Locally advanced unresectable cancer has
spread outside the pancreas to nearby blood
vessels or other tissues and cannot be treated
Metastatic cancer has spread outside the
pancreas to organs and tissues far away in the
Your state of general health will be rated using a
performance status scale. The PS (
tatus) indicates a person’s general level of fitness.
A commonly used scale is the ECOG (
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
aggressive cancer treatment. See Part 4 for more
information on supportive care.
Cancer tests are used to find cancer, plan
treatment, and check how well treatment is
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 (
tatus) indicates a
person’s general level of fitness.