NICE guideline 3: Working out how far pancreatic cancer has spread (staging)

If you have been diagnosed with pancreatic cancer, you may need more tests to find out what stage the cancer is. The stage describes the size of the cancer and if it has spread outside the pancreas or to other parts of the body. This will help the doctor work out what treatment you may need.

3.1 If you have recently been diagnosed with pancreatic cancer but haven’t already had a CT scan, you should be offered one. The scan should include the chest, abdomen (tummy) and pelvis (area below the belly button).

3.2 If you have localised pancreatic cancer and will be having surgery, chemotherapy or radiotherapy, you should be offered an FDG-PET/CT scan.

The FDG-PET/CT scan helps to confirm whether it is possible to remove the cancer.

Localised pancreatic cancer is cancer that is contained inside the pancreas.

3.3 If the doctors need more information to decide on your care, they should consider one or more of the following:

• an MRI scan to check if the cancer has spread to the liver
• an endoscopic ultrasound (EUS) to help work out the stage of the cancer
• a laparoscopy if surgery is a possibility, but there is a chance the cancer may have spread.

Published: April 2025

Review date: April 2028