Pancreatic cancer reaches the end stage, also known as Stage IV or metastatic pancreatic cancer, when cancer spreads beyond the pancreas to nearby organs, including the lungs, liver and abdominal lining. Because pancreatic cancer is difficult to spot in its early stages, the cancer often has already reached this stage by the time of detection.
Possible symptoms at this stage could include pain in the upper abdomen, weight loss and declining appetite, sudden depression and jaundice, or a yellowing of the skin and eyes. Once doctors have diagnosed pancreatic cancer, they can determine whether it's in the end stages through laparoscopy--a lighted tube with a video camera to explore the abdomen--CT scans or MRIs. Doctors also might target specific areas to check for cancer, such as a chest X-ray for the lungs, a bone scan or a blood test. In some cases, doctors might not discover that the cancer is in its end stages until attempting surgery.
End stage pancreatic cancer can cause significant, disabling pain. Patients might feel a severe pain in the upper abdomen that radiates to the upper and middle back. Tumors put pressure on other organs in the abdomen, causing this pain. The pain could be a continuous feeling of discomfort, a cramp or a sharp, stabbing pain. Eating or lying down might make the pain worse. In addition, patients might experience nausea or vomiting, as the tumors can impede parts of the digestive tract. Adding to the discomfort, the cancer can cause bile acids to accumulate in the skin. This will make the skin itch severely.
Patients face a grim prognosis by the time pancreatic cancer reaches its end stages. Doctors usually consider the cancer inoperable by this point, and the disease is almost always fatal.
However, some treatments can both prolong a patient's life and ease some of the suffering. Depending on the overall health of the patient, chemotherapy can both ease symptoms and extend a patient's life. Pain relief is key. Doctors can accomplish this either through medications or by injecting alcohol and other chemicals into the area around the pancreas. This damages the nerves that cause the pain.
Doctors might also prescribe medication to help maintain nutrition. The cancer changes metabolism, and treatments and symptoms might further decrease a patient's appetite, but healthy nutrition will help to prolong a patient's life. Doctors might offer clinical trials, such as vaccines or cancer growth inhibitors. The Mayo Clinic also recommends looking into alternative methods to manage pain, including acupuncture, massage or relaxation techniques. In addition, support groups dedicated to pancreatic cancer patients might provide some comfort.