3D illustration of human anatomy, pancreas featured
When pancreatic cancer spreads to other parts of the body, it is referred to as metastatic pancreatic cancer, or Stage IV pancreatic cancer.

Metastatic Pancreatic Cancer

Metastatic pancreatic cancer is a type of cancer which starts in the pancreas and then spreads to other parts of the body. In this article, we discuss what metastatic pancreatic cancer is, along with its prognosis, symptoms, and treatment options.

What Is Metastatic Pancreatic Cancer?

The word "metastatic" means cancer that spreads from one part of the body to another. Metastatic pancreatic cancer starts in the pancreas and spreads to the surrounding organs, including the liver, stomach, spleen and intestines.

The pancreas is a small gland which is shaped like a leaf and located just below the stomach. Its functions include excreting enzymes which aid the digestive process and the hormones insulin and glucagon, which help to control blood sugar.

The most common type of pancreatic cancer is called adenocarcinoma, and this starts in the enzyme-producing cells of the pancreas.

When pancreatic cancer begins to spread, it usually affects the lymph nodes and blood vessels surrounding the pancreas first. It is known as locally advanced or locoregional pancreatic cancer. At this stage, cancerous cells may also spread to the bile duct, stomach, or duodenum (the upper section of the small intestine).

When cancerous cells spread further to affect the liver, spleen, large intestine, lungs, or peritoneum (the lining of the abdominal cavity), this is known as metastatic pancreatic cancer.

Metastatic Pancreatic Cancer Prognosis

One of the most significant problems with metastatic pancreatic cancer is that it does not usually cause any symptoms in its early stages. In the early stages of metastatic pancreatic cancer, it often remains undetected until it has already begun to spread. At this point, it becomes far more challenging to treat metastatic pancreatic cancer effectively, and the prognosis is generally poor.

The prognosis for metastatic pancreatic cancer is determined using something called the "five-year survival rate." This prognosis means the percentage of people who will still be alive five years after their initial diagnosis.

The outlook for pancreatic cancer varies significantly depending on how advanced it is when first diagnosed. According to the American Cancer Society, the five-year survival rates for pancreatic cancer are as follows:

  • Localized (cancerous cells are only found in the pancreas): 34%
  • Locoregional (cancerous cells have spread to surrounding tissues): 12%
  • Metastatic (cancerous cells have spread to other organs): 3%
  • Overall (all stages combined): 9%

Since pancreatic cancer is often not diagnosed until it has already begun to spread, the overall five-year survival rate is low. However, the prognosis can be significantly improved if symptoms are spotted early.

Symptoms of Metastatic Pancreatic Cancer

The symptoms of metastatic pancreatic cancer can be challenging to detect and are often confused with those of other conditions. However, there are some early warning signs to look out for, and you should see your physician if you experience any of the following:

  • Jaundice (yellowing of the skin and eyes)
  • Pain in the back or abdomen which may be worse when lying down or after food
  • Loss of appetite
  • Unexpected weight loss
  • Dark yellow or orange urine
  • Pale or loose stools
  • Itching
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Other symptoms which may occur as the cancer progresses include:

  • Nausea and vomiting
  • Indigestion
  • Changes in bowel habits
  • Fever
  • Blood clots or deep vein thrombosis
  • Diabetes

Many of these symptoms can be associated with other, less serious conditions. However, they should never be ignored. Early diagnosis is key to improving your prognosis, and so the above symptoms should always be investigated urgently.

Treatment for Metastatic Pancreatic Cancer

The best treatment for metastatic pancreatic cancer depends on how advanced the disease has become. Pancreatic cancer that is localized in the pancreas or surrounding lymph nodes may be resectable, meaning that the cancerous cells can be removed surgically.

However, once the cancer spreads to the surrounding blood vessels and organs, it becomes more difficult to perform surgery. Metastatic pancreatic cancer that has become inoperable is classed as unresectable.

Whether surgery can be performed or not, a course of chemotherapy or chemotherapy combined with radiotherapy will usually be recommended. These treatments aim to destroy any cancerous cells that remain in the body after surgery or to reduce the extent to which they have spread.

The most commonly used chemotherapy drug for pancreatic cancer is called gemcitabine (Gemzar). This can be combined with other drugs such as albumin-bound paclitaxel (Abraxane), erlotinib (Tarceva), or capecitabine (Xeloda).

Another drug regimen which may be effective is a combination of four different drugs known as FOLFIRINOX. This combination therapy can help to extend patients' lives, but also increases the risk of side effects.

Immunotherapy is another treatment for pancreatic cancer. This therapy stimulates the patient's immune system to identify and destroy cancerous cells. This option may be beneficial for people with unresectable cancer or cancer that returns after surgery. However, it is not suitable for treating all types of pancreatic cancer.

Other pancreatic cancer treatments are focused on relieving symptoms and improving the patient's quality of life as the disease progresses.


The bottom line is that metastatic pancreatic cancer can be treated, but for the best outcomes, it needs to be diagnosed early. Therefore, it is essential to keep an eye out for possible pancreatic cancer symptoms and report them to your physician immediately.