Treatment Options For Stage 4 Pancreatic Cancer

What is stage IV of pancreatic cancer?

Pancreatic cancer is staged primarily using the TNM method of staging cancers, T stands for Tumour, N stands for node and M for Metastasis. Tumour shows the size of the primary tumour, Node shows the presence of cancer in the lymph nodes and Metastasis is the spreading of cancer from the primary tissue to the other tissues and organs.

Visual representation of a microscopic photo of pancreatic cancer

In this stage, the pancreatic cancer cells have spread to other parts of the body as well. The tumour size is bigger than 4 cm in size and there could be more number of cancerous lymph nodes. The staging here could be (ANY T, ANY N, M1).

Treatment options:

The treatment options for pancreatic cancer depend on the stage of cancer, the spreading of the tumour and the location of cancer along with the patient’s symptoms and response to treatment. Staging is an important factor to decide the course of treatment of this cancer. Pancreatic cancer is often diagnosed at later stages as it does not show symptoms in the early stages. Stage 4 is a late stage of cancer and it cannot be cured at this point though there are treatment options aimed to improve the quality of life.

Palliative surgery:

In cases where the cancer has spread and cannot be completely removed by surgery, the priority is to alleviate or palliate the symptoms of the cancer to improve the quality of life and to make the patient more comfortable. A stent can be placed to remove the blockage caused by the tumour to open the duct and restore the flow of substances. If it is not possible to open the duct through a stent, a bypass procedure may be done too.


Chemotherapy is the use of drugs to counter or kill the cancerous cells in the body. Unlike surgery or other targeted therapies, this treatment is more widespread and can kill the cancer that has spread to other tissues or organs of the body too and hence is the prefered treatment for metastasized cancers and those that are likely to spread too.


Chemoradiation is the combination of chemotherapy and radiation therapy that can be given before or after surgery aimed to remove cancer tumours. The chemotherapy drugs make the cells more sensitive and susceptible to radiation, though the side effects are worse too and is opted when the cancer has spread too much.

Radiation therapy:

Radiation therapy uses high dosage of radiation to kill cancer cells and shrink the cancerous tumours. It is not typically used to treat cancer that has already spread to the other parts of the body and is mainly used post surgery as a part of adjuvant therapy.

Clinical trials:

Clinical trials is another option for advanced stages of cancer that might have more complications and side effects than the lower stages. Clinical trials focus on new treatments or combination of existing treatments by trying new approaches. While there is some uncertainty attached to clinical trials, it may be the best chances for cases where the traditional treatment have not shown much improvement.


The average survival period for stage IV pancreatic cancer is about two to six months and the disease cannot be cured at this point and treatment aims to ease the patient’s condition and symptoms. The five year survival rate for stage 4 pancreatic cancer is about 1%.

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