Stage 3 pancreatic cancer

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

Stage 3 is part of the number staging system. There are 4 stages of pancreatic cancer, numbered 1 to 4.

Doctors can also use the TNM system to stage your cancer. TNM stands for Tumour, Node, Metastases. 

Stage 3 can mean that the cancer is any size within the pancreas and has spread to 4 or more nearby lymph nodes Open a glossary item.

In TNM staging, this is the same as T1, 2 or 3, N2, M0.

Diagram showing stage 3 cancer of the pancreas

Or stage 3 can mean the cancer has started to grow outside the pancreas into the major blood vessels nearby. It may or may not have spread into the lymph nodes. It hasn't spread to any other areas of the body.

In TNM staging, this is the same as T4, Any N, M0.

Diagram showing an example of stage 3 cancer of the pancreas

Stage 3 cancer may also be called locally advanced cancer.

Treatment for stage 3 pancreatic cancer

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

  • your type of cancer (the type of cells the cancer started in)
  • where the cancer is 
  • if they can remove (resect) the cancer
  • other health conditions that you have

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

Chemotherapy and radiotherapy are generally the main treatments for stage 3 pancreatic cancer.

Most people start with a course of chemotherapy.

A few people go on to have surgery to remove the cancer. After surgery you usually have more chemotherapy. This usually starts once you have recovered enough from the operation.

If you can’t have surgery, you may have a short course of radiotherapy after chemotherapy. This is called stereotactic body radiotherapy Open a glossary item or SABR. Or you may have a combination of radiotherapy and chemotherapy.

If you’re not well enough to have surgery or chemotherapy you may have radiotherapy.

If you are not able to have an operation to remove the cancer you may have other types of surgery or a procedure. This is to help control or prevent symptoms. For example, you may have a small tube (stent) put in to the bile duct Open a glossary item to help clear a blockage and prevent symptoms such as jaundice Open a glossary item.

A small number of people may have a targeted cancer drug Open a glossary item or immunotherapy drug Open a glossary item.

You may have treatment as part of a clinical trial Open a glossary item.

Other stages

  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2017

  • BMJ Best Practice Pancreatic Cancer
    H M Kocher and others
    BMJ Publishing Group, last updated November 2022

  • Pancreatic cancer in adults: diagnosis and management
    National Institute for Health and Care Excellence (NICE), February 2018

  • Pancreatic cancer
    J D Mizrahi and others
    The Lancet, June 2020. Volume 395, Pages 2008 to 2020

  • Principles and practice of oncology (11th edition)
    VT De Vita, S Hellman and SA Rosenberg
    Lippincott, Williams and Wilkins, 2019

  • Cancer of the Pancreas: European Society Medical Oncology Clinical Practice Guidelines
    M Ducreux and others
    Annals of Oncology, 2015. Volume 26, Supplement 5, v56 to v68

Last reviewed: 
31 Mar 2023
Next review due: 
31 Mar 2026

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