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Stage 4 Pancreatic Cancer

Stage 4 Pancreatic Cancer

Stage 4 Pancreatic Cancer is an advanced stage of pancreatic cancer in which the tumor metastasizes to other organs. 53% of diagnosed pancreatic cancer cases are in the 4th stage. It is not possible to fully cure, but treatments increase the life expectancy of the patient while improving their quality of life.

Stage 4 pancreatic cancer is a stage in which pancreatic cancer metastasizes to organs such as the intestine, lung, liver and stomach. At this stage, the 5-year survival rate is approximately 3%. On average, most patients survive one year after diagnosis. The nature and spread of the cancer limit the available treatment options.

What is Pancreatic Cancer?

The pancreas is the internal and external gland located at the back of the stomach. It controls the blood’s level of insulin and glucose obtained from foods consumed. It produces enzymes for the digestion of food. In addition, it has many important functions such as breaking down proteins and digesting fatty substances. Uncontrolled growth of cells in this organ causes pancreatic cancer. It is a rapidly spreading and aggressive cancer type.

Types of Pancreatic Cancer

The most common type of pancreatic cancer is pancreatic adenocarcinoma. Most of the pancreas is made up of exocrine cells. Exocrine glands produce pancreatic enzymes to break down fats from food. Abnormal growth of exocrine cells causes a pancreatic exocrine tumor. Pancreatic Adenocarcinoma makes up 95% of pancreatic cancer cases.

Endocrine cells, on the other hand, are less common in the pancreas but have very important functions. It controls the sugar level in the blood by producing insulin and glucagon hormones. Uncontrolled growth of these cells causes a pancreatic neuroendocrine tumor. In addition to these two common pancreatic cancers, there are also less common types. These types are listed below:

  • Ampullary cancer
  • Adenosquamous carcinomas
  • Squamous cell carcinoma
  • Signet ring carcinomas
  • Undifferentiated carcinomas

Stages of Pancreatic Cancer

Pancreatic cancer is classified into 4 different stages after its earliest stage, stage 0. A staging system called the American Joint Committee on Cancer (AJCC) TNM system is used. This system’s evaluation is based on the size and spread of the cancer. The TNM definition contains the following values:

  • Tumor (T): The size of the tumor and its expansion into the vessels outside the pancreas.
  • Lymph Nodes (N): Spread of tumor to lymph nodes
  • Metastasized (M): Spread of cancer cells into lymph nodes and other organs such as the liver, peritoneum, lungs, and bones

Using these values, pancreatic cancer is divided into 4 stages:

  • Stage 0: Cancer cells are found in duct cells and have not gone deep into the tissues. Carcinoma can be defined as in situ. No splashes to lymph nodes or distant parts of the body.
  • Stage IA: Tumor smaller than 2 cm is seen in the pancreas. It has not yet spread out of the pancreas or to the lymph nodes.
  • Stage IB: The tumor in the pancreas has reached between 2 cm and 4 cm. It is not seen outside the pancreas.
  • Stage IIA: The tumor has become larger than 4 cm, but it is not found in lymph nodes.
  • Stage IIB: The tumor has become larger than 4 cm and has spread to the lymph nodes. At this stage, tumors are found in at most 3 lymph nodes. It has not metastasized to other organs.
  • Stage III: The tumor is seen in 4 or more regional lymph nodes or has spread to nearby arteries and veins. It is not seen in other organs.
  • Stage IV: Cancer cells have spread to other organs such as liver, lungs and bones.

Separate treatments are recommended for each stage of pancreatic cancer. Stage 4 pancreatic cancer is the most difficult stage to treat.

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Stage 4 Pancreatic Cancer Symptoms

Pancreatic cancer is known as the “silent disease”. The absence of any significant symptoms in the early stages often causes the diagnosis to be made at the final stage.

Since the tumor causes obstruction in the bile duct, yellowing of the skin and eyes, and darkening of the urine (urine) may occur due to Jaundice.

Pancreatic cancer symptoms may vary depending on the patient’s condition, but the most common symptoms are:

  • Swelling in the arms and legs
  • Burning sensation and bloating in the stomach
  • Loss of appetite and weight loss
  • Pain in the abdomen and back area
  • Nausea and vomiting

Stage 4 Pancreatic Cancer Treatments

Stage 4 pancreatic cancer treatments cannot cure the disease, but rather, aim to prolong the life of the patient, suppress symptoms and improve their quality of life.


Chemotherapy is the main treatment method used for stage 4 pancreatic cancer. It is the use of drugs to kill cancer cells. It aims to extend the life span of the patient. The drugs can be taken orally or intravenously. Gemcitabine and combinations with other drugs are used for pancreatic cancer.

Chemoradiation Therapy

Chemoradiation is the combination of chemotherapy and radiation therapy. It is used to slow the growth of the tumor in the pancreas. It does not affect metastasized organs such as liver and lungs. It can also be applied to shrink the tumor after pancreatic surgery.


Surgical intervention can be performed to alleviate pancreatic cancer symptoms. As the pancreatic tumor grows, it can block the bile duct. In these cases, duct bypass surgery directly connects the bile duct to the small intestine to get around the blockage.  Another option is a stent
can be placed to keep the bile duct open.

The tumor can prevent food from reaching the excretory system from the stomach. In this case, gastric bypass connects the stomach directly to the intestines.

Stage 4 Pancreatic Cancer Clinical Trials

Pancreatic cancer is a difficult type of cancer to treat. Researchers and various organizations continue to search for more effective solutions for this disease. It aims to improve existing treatments, reduce side effects, and develop new therapy methods for pancreatic cancer patients. Massive Bio determines the research study that best suits you among hundreds of clinical trials and brings you together with these clinics. If you are looking for a clinical research suitable for your disease, you can contact us.


  • Noshin says:

    My father in law just got diagnosed with pancreatic cancer stage four.

    • Cancer Treatment Expert says:

      Hi Noshin, we are sorry to hear of your father in law’s diagnosis. There are various treatment options available for patients with newly diagnosed, advanced stage pancreatic cancer, including clinical trials. Most clinical trials provide treatment that is already approved in combination with a drug or drugs that is being studied. We would love the opportunity to support him and your family in his cancer journey. Please reach out to our experienced Patient Relations Coordinators at 844-627-7246 or to let us help you find the best treatment options.

  • Gayathiri says:

    My sister 30 years old is affected by ewing sarcoma of pancreas.she was diagnosed after it metastatic to liver.taking chemotherapy for past 18 months.even then back pain is continuing during day 16-21 of chemotherapy cycles. What can be done for her painless life at this stage.plz guide

    • Cancer Treatment Expert says:

      Hi Gayathiri. We are so sorry to hear about your sister’s pain. The best thing to do is to speak with her doctor. For most patients, morphine or similar drugs can help control the pain. Pain medicines work best when they are taken on a regular schedule.

  • Medina says:

    My Mother in Law was diagnosed last November with Stage 4 Pancreatic Cancer it had Matastasized at diagnosis she was told nothing can be offered it’s spread , I’ve just read that people with Mets at diagnosis can be treated, how can they decide who lives and who doesn’t or have I read this wrong ?

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