Advanced Pancreatic Cancer

What Is Advanced Cancer?

Pancreatic cancer is advanced when it is unresectable, or can’t be removed by surgery. The cancer has spread to nearby blood vessels or lymph nodes, somewhat outside the pancreas or to distant organs (metastasis). This is usually stage III or IV. Staging is the process doctors use to describe the cancer’s size and if it has spread.

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

Advanced cancer does not mean you should give up hope or that there is not treatment. Treatments for advanced pancreatic cancer may shrink the cancer, slow its growth, relieve symptoms or a mix of these.

Some doctors use different definitions for advanced cancer. If your doctor says the cancer is advanced, ask what that means for the patient.

What Is Metastatic Cancer?

Metastatic cancer is when the disease has spread to another area of the body. Pancreatic cancer often spreads to the liver, abdominal wall, lungs, bones or faraway lymph nodes.

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

What Is Unresectable Cancer?

When a tumor cannot be removed through surgery, it is unresectable. The tumor has either spread to distant organs or cannot be completely removed with surgery.

Cancer that is unresectable may be:

Locally advanced: the cancer has spread outside the pancreas, to nearby blood vessels, to nearby lymph nodes or a mix of these, but has not spread to another organ
Metastatic: the cancer has spread to another organ

What Are Symptoms of Advanced Pancreatic Cancer?

Pancreatic cancer may cause only vague, unexplained symptoms, such as:

Pain, usually in the abdomen or back
Weight loss
Jaundice (yellowing of the skin, eyes or both) with or without itching
Loss of appetite
Nausea
Change in stool
Pancreatitis
Recent-onset diabetes

If you are experiencing one or more of these symptoms, speak to your doctor immediately and reference pancreatic cancer.

Many of these symptoms can show at any stage. A person with advanced pancreatic cancer may also have ascites (fluid in the abdomen), fatigue and blood clots.

How Is Advanced Cancer Found?

Imaging studies are the only way to see a pancreatic tumor. Doctors often use a computed tomography (CT) scan to see if the cancer has spread to nearby organs. They may use other tests, such as MRI, PET and ERCP, but these are less common.

Learn more about pancreatic cancer diagnosis.

Why Is Early Detection Important for Pancreatic Cancer?

Today, there is no established way or tool to find pancreatic cancer early.

When diagnosed early, surgery offers the best chance of controlling pancreatic cancer for a long time. Most patients are diagnosed at later stages and are not eligible for surgery, though. So, tests to find pancreatic cancer in the earliest stages are urgently needed.

As early detection study continues and as technology gets better, researchers predict that we will make progress toward finding the disease earlier.

What Are Treatments for Advanced Pancreatic Cancer?

Treatment for advanced pancreatic cancer is usually chemotherapy. Chemotherapy travels through the bloodstream to reach cancer cells that are in many places throughout the body.

This treatment may shrink the tumors or slow their growth and may help patients live longer. You may have more treatment choices through clinical trials.

Pancreatic cancer patients who participate in clinical research have better outcomes. Every treatment available today was approved through a clinical trial. The Pancreatic Cancer Action Network strongly recommends clinical trials at diagnosis and during every treatment decision.

Supportive (palliative) care is also important at any stage to help control side effects for better quality of life.

It is important to know the patient’s goals when deciding treatment. PanCAN Patient Services can give you more information about any of these options.

Getting a Second Opinion

If you have been diagnosed with pancreatic cancer of any stage, including advanced cancer, you have a right to get a second opinion as needed. This may help confirm your diagnosis and make sure that all treatment options have been offered and explained.

Seeing pancreatic cancer specialists, physicians who diagnose and treat a high volume of pancreatic cancer patients, improves outcomes. The Pancreatic Cancer Action Network strongly recommends you consult with pancreatic cancer specialists who have experience diagnosing and treating the disease.

PanCAN Patient Services can give you a list of pancreatic cancer specialists in your area.

Common Concerns and Emotions when Facing Advanced Cancer

Staying hopeful
Fear of the unknown, the future and separation
Finding support
Practical concerns, such as finances, insurance and childcare
Fear of recurrence after successful treatment
Depression and anxiety
Deciding which treatments are best for your goals

PanCAN Patient Services has information and resources to help with these concerns.

What Is Recurrence?

Cancer may recur, or come back after treatment. It may come back to the pancreas or to another place in the body, like the liver. Recurrent cancer is often treated similarly to metastatic pancreatic cancer.

What Is Hospice?

Hospice offers high-quality care at the end of a person’s life. Hospice care may be used when life expectancy is six months or less and further treatments will not help. It focuses on relieving symptoms and increasing comfort. Patients can discuss hospice care with their doctors at any time.

Grief

Everyone experiences grief differently. Losing someone you care about can cause difficult feelings, physical sensations and behaviors. These reactions are different for each person, and feelings of grief will come and go unpredictably.

Grief is not permanent. While you will continue to miss your loved one, the intense reactions that follow loss will decrease over time. Strong feelings may come back around significant dates, such as birthdays or holidays. If your grief reactions do not subside over time, you may need added support.

PanCAN Patient Services has grief and supportive resources. We can also connect you to a volunteer who has lost a loved one to pancreatic cancer and can provide support and encouragement by phone or email.

We’re Here to Help

For free, in-depth and personalized resources and information on pancreatic cancer – including staging, treatment and support – contact PanCAN Patient Services. We can also connect you with others who have been in your shoes through our Survivor and Caregiver Network.

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 https://www.pancan.org/privacy/.

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