Stage IV Pancreatic Cancer

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Stage 4 pancreatic cancer, showing the primary tumor in the pancreas and metastasis (spread) throughout body. Stage IV Pancreatic Cancer

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What Is Stage IV Pancreatic Cancer?

Doctors use staging to describe the cancer’s size and location. Stage IV means the cancer metastasized, or spread, to another part of the body. The tumors may be any size.

Cancer at this stage may also be called metastatic or advanced cancer.

Most pancreatic cancer patients are diagnosed at stage IV. Patients diagnosed at an earlier stage can also develop stage IV cancer if it spreads.

Why Is Staging Needed?

The cancer’s stage helps your doctors figure out your treatment choices.

Where Does Stage IV Pancreatic Cancer Spread?

Pancreatic cancer often spreads to the:

  • Liver
  • Abdominal wall
  • Lungs
  • Bones
  • Faraway lymph nodes

Though the cancer has spread to other areas of the body, it is still called pancreatic cancer because that is where it started.

What Are Treatments for Stage IV Pancreatic Cancer?

Stage IV patients usually get a treatment that travels through the bloodstream to reach cancer cells that are in many places throughout the body. Stage IV treatment is usually chemotherapy. Clinical trials may also give you more choices.

The cancer cannot be removed by surgery (unresectable) at this stage.

The Pancreatic Cancer Action Network strongly recommends:

  • Discussing your treatment goals with your healthcare team and knowing all of your options
  • Clinical trials at diagnosis and during every treatment decision
  • Molecular profiling of your tumor to help determine the best treatment options
  • Symptom management and supportive (palliative) care early in your diagnosis as well as during and after treatment

For more information and resources about pancreatic cancer treatment, including clinical trials and molecular profiling, contact PanCAN Patient Services.

How to Manage Stage IV Side Effects

Patients may also get treatment to control side effects, called supportive (palliative) care. This treatment focuses on comfort, quality of life and the patient’s total well-being. Supportive care can go with cancer-fighting treatments or be the focus of care.

Proper nutrition and choosing the right foods can also help a patient better tolerate treatment, control side effects and improve quality of life.

The Pancreatic Cancer Action Network strongly recommends that patients have access to pancreatic enzymes and see a registered dietitian.

Contact PanCAN Patient Services for more information about supportive care, pancreatic enzymes and nutrition for pancreatic cancer patients. They can also give you a list of dietitians in your area.

Why Is Stage IV Hard to Treat?

Doctor examines a stage 4 pancreatic cancer patient. Pancreatic cancer is hard to treat at any stage. The more the cancer spreads, the more challenging treatment becomes.

Surgery is the best option for long-term survival of pancreatic cancer. Because stage IV cancer has spread to different parts of the body, it cannot be removed by surgery.

Some patients also respond better to a certain treatment than others for unknown reasons. Stage IV patients may have to try different treatments before one works for them.

Also, a dense tissue layer, called the stroma, surrounds pancreatic tumors. This makes it hard for treatment to reach the tumor. Researchers are studying ways to get treatment through the stroma to make it more effective.

Questions to Ask Your Doctor when Diagnosed with Stage IV Pancreatic Cancer

  • What treatment(s) do you recommend? Why?
  • Are there any clinical trials available to me at this hospital? At other local hospitals?
  • Do you offer molecular profiling or refer patients to the Pancreatic Cancer Action Network’s Know Your Tumor® precision medicine service to help find other treatment options?
  • What medicine(s) will you prescribe to help control my side effects? Do these medicines cause other side effects?
  • Do I need to change my diet?
  • Is there a dietitian you recommend?
  • Will I need to take pancreatic enzymes or vitamins? If so, how often?
  • Should I make any lifestyle changes?
  • What support programs are there for me and my family?
  • Whom can I speak with about my financial or insurance concerns?
  • Who can help me navigate the medical system? Is there an oncology social worker or patient navigator at this hospital?

We’re Here to Help

For more free information about pancreatic cancer and its treatment, contact PanCAN Patient Services. We can also give you a list of doctors near you who specialize in pancreatic cancer and can help you know your options.

PanCAN Patient Services can also connect you with others who have been diagnosed with stage IV pancreatic cancer and can offer support and hope through the Survivor & Caregiver Network.

Related Topics

  • Clinical Trials

    See why patients who participate in clinical research have better outcomes.

  • Treatment Types

    Explore treatment options, including standard treatments and clinical trials.

  • Self-Advocacy

    Understand how patients can take an active role in their care.

The Pancreatic Cancer Action Network would like to thank Kathleen Wagner and support from the Hamill Foundation and the Pickelner Fund for Pancreatic Cancer Research at MD Anderson Cancer Center for the illustrations on this page.

Information reviewed by PanCAN’s Scientific and Medical Advisory Board, who are experts in the field from such institutions as University of Pennsylvania, Memorial Sloan-Kettering Cancer Center, Virginia Mason Medical Center and more.

Information provided by the Pancreatic Cancer Action Network, Inc. (“PanCAN”) is not a substitute for medical advice, diagnosis, treatment or other health care services. PanCAN may provide information to you about physicians, products, services, clinical trials or treatments related to pancreatic cancer, but PanCAN does not recommend nor endorse any particular health care resource. In addition, please note any personal information you provide to PanCAN’s staff during telephone and/or email communications may be stored and used to help PanCAN achieve its mission of assisting patients with, and finding cures and treatments for, pancreatic cancer. Stored constituent information may be used to inform PanCAN programs and activities. Information also may be provided in aggregate or limited formats to third parties to guide future pancreatic cancer research and education efforts. PanCAN will not provide personal directly identifying information (such as your name or contact information) to such third parties without your prior written consent unless required or permitted by law to do so. For more information on how we may use your information, you can find our privacy policy on our website at