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How Long Do You Have to Live with Stage 4 Pancreatic Cancer?

Reviewed on 1/11/2021

Cancer
Pancreatic adenocarcinoma is the most common type of pancreatic cancer, accounting for about 95% of cancers of the pancreas.

Life expectancy for pancreatic cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis. 

Pancreatic cancer 5-year survival rates chart
Pancreatic cancer stageSurvival rate
Localized (no sign cancer has spread outside the pancreas)37%
Regional (cancer has spread outside the pancreas to nearby structures or to nearby lymph nodes)12%
Distant (cancer has spread to distant parts of the body such as the lungs, liver, or bones)3%

The life expectancy for stage 4 pancreatic cancer is very low, estimated to be about three to five months. By stage 4, pancreatic cancer has spread to and damaged surrounding organs, which makes it difficult to treat. 

What Is Pancreatic Cancer?

Pancreatic cancer occurs when cells in the pancreas grow abnormally out of control.

Pancreatic adenocarcinoma is the most common type of pancreatic cancer, accounting for about 95% of cancers of the pancreas. Pancreatic neuroendocrine tumors (NETs), or islet cell tumors, are less common but usually have a better prognosis.

What Are Symptoms of Pancreatic Cancer?

Symptoms of pancreatic cancer include: 

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What Causes Pancreatic Cancer?

Pancreatic cancer is believed to be caused by genetic changes (mutations), however, the exact cause for these mutations is unknown. 
Risk factors for developing pancreatic cancer include: 

  • Tobacco use
    • This is one of the most common causes of pancreatic cancer 
    • About 25% of pancreatic cancers are thought to be caused by cigarette smoking
    • The risk of developing pancreatic cancer is about twice as high among smokers compared to those who have never smoked
  • Being overweight or obese 
    • People with a body mass index (BMI) of 30 or more are about 20% more likely to develop pancreatic cancer
    • Gaining weight as an adult 
    • Carrying extra weight around the waistline even in people who are not overweight
  • Diabetes
  • Chronic pancreatitis
  • Workplace exposure to certain chemicals such as those used in the dry cleaning and metal working industries 
  • Age
    • Risk increases with age
    • About two-thirds of patients are at least 65 years old
    • The average age at diagnosis is 70
  • Gender: men are slightly more likely to develop pancreatic cancer than women (this may be due to greater tobacco use in men)
  • Race: African Americans are slightly more likely to develop pancreatic cancer than whites
  • Family history
  • Inherited genetic syndromes

How Is Pancreatic Cancer Diagnosed?

Pancreatic cancer is diagnosed with a patient history and physical exam, along with tests such as:

  • Imaging tests 
    • Computed tomography (CT) scan
    • Multiphase CT scan or a pancreatic protocol CT scan
    • CT-guided needle biopsy
  • Magnetic resonance imaging (MRI)
    • MR cholangiopancreatography (MRCP)
    • MR angiography (MRA)
  • Ultrasound
  • Cholangiopancreatography
    • Endoscopic retrograde cholangiopancreatography (ERCP)
    • Magnetic resonance cholangiopancreatography (MRCP)
    • Percutaneous transhepatic cholangiography (PTC)
    • Positron emission tomography (PET) scan
    • Angiography
  • Blood tests
  • Biopsy
    • Percutaneous (through the skin) biopsy
    • Endoscopic biopsy
    • Surgical biopsy
  • Genetic counseling and testing
    • Can help determine what treatments might be useful
    • Family members of the patient may consider genetic counseling and testing 

What Is the Treatment for Pancreatic Cancer?

Treatment for pancreatic cancer includes one or more of the following:

  • Surgery 
    • Potentially curative surgery: used when tests suggest it’s possible to remove (resect) all the cancer
      • Whipple procedure (pancreaticoduodenectomy): removes a cancer in the head of the pancreas. 
      • Distal pancreatectomy: removes only the tail of the pancreas or the tail and a portion of the body of the pancreas, along with the spleen 
      • Total pancreatectomy: removal of entire pancreas, as well as the gallbladder, part of the stomach and small intestine, and the spleen
    • Palliative surgery: used if the cancer is too widespread to be removed completely; done to relieve symptoms or to prevent complications like a blocked bile duct or intestine
      • Stent placement to relieve a blocked bile duct 
      • Bypass surgery to relieve a blocked bile duct
  • Ablation or embolization treatments 
    • Ablation: used to destroy tumors, usually with extreme heat or cold
      • Works best for tumors no more than about 2 cm (just under an inch) 
      • Radiofrequency ablation (RFA) 
      • Microwave thermotherapy 
      • Ethanol (alcohol) ablation (also known as percutaneous ethanol injection) 
      • Cryosurgery (also known as cryotherapy or cryoablation) 
    • Embolization 
      • Arterial embolization (also known as trans-arterial embolization or TAE) 
      • Chemoembolization (also known as trans-arterial chemoembolization or TACE
      • Radioembolization 
  • Radiation therapy 
    • External beam radiation therapy
  • Chemotherapy 
  • Targeted therapy
    • EGFR inhibitor: erlotinib (Tarceva
    • PARP inhibitor: olaparib (Lynparza) 
    • NTRK inhibitors: larotrectinib (Vitrakvi) and entrectinib (Rozlytrek)
  • Immunotherapy 
    • PD-1 inhibitor: pembrolizumab (Keytruda) 
  • Pain control 

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Reviewed on 1/11/2021
References
https://www.cancer.org/cancer/pancreatic-cancer.html

https://healthresearchfunding.org/stage-4-pancreatic-cancer-life-expectancy/
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