Stage 4 pancreatic cancer

The stage of a cancer tells the doctor about its size and whether it has spread. The tests and scans you have when diagnosing your cancer give some information about the stage.

Doctors can use a number system (stages 1 to 4) or the TNM system to stage your cancer. TNM stands for Tumour, Node, Metastases. 

The information here is about stage 4 pancreatic cancer from the number staging system.

Stage 4 means that the cancer has spread to other areas of the body, such as the liver or lungs.

Diagram showing M1 pancreatic cancer from the TNM staging system

Your doctor might call this advanced (metastatic) cancer.

In TNM staging, this is the same as Any T, Any N, M1.

Treatment for stage 4 pancreatic cancer

The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:

  • your type of cancer (the type of cells the cancer started in)
  • where the cancer is 
  • other health conditions that you have

The stage of the cancer and these other factors can also give an idea of your outlook (prognosis).

For stage 4 pancreatic cancer, the aim of treatment is to help control or prevent symptoms. Unfortunately, treatment won’t cure this stage of cancer. But it might help you live longer and relieve symptoms.

Generally, the main treatment is chemotherapy or radiotherapy. The treatment you have depends on how well you are.

A small number of people may have a targeted cancer drug Open a glossary item or immunotherapy Open a glossary item drug.

Other treatments may include:

  • surgery or a procedure to prevent or relieve symptoms. For example, you may have a small tube (stent) put into the bile duct Open a glossary item to help clear a blockage and prevent symptoms such as jaundice Open a glossary item
  • medicines to help with pain control or other symptoms such as sickness
  • enzyme replacement therapy to help digest fats and protein if the pancreas is not working properly
  • blood sugar control – you may have diabetes Open a glossary item if your pancreas isn’t working properly

You might have treatment as part of a clinical trial Open a glossary item


  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2017

  • BMJ Best Practice Pancreatic Cancer
    H M Kocher and others
    BMJ Publishing Group, last updated November 2022

  • Pancreatic cancer in adults: diagnosis and management
    National Institute for Health and Care Excellence (NICE), February 2018

  • Pancreatic cancer
    J D Mizrahi and others
    The Lancet, June 2020. Volume 395, Pages 2008 to 2020

  • Principles and practice of oncology (11th edition)
    VT De Vita, S Hellman and SA Rosenberg
    Lippincott, Williams and Wilkins, 2019

  • Cancer of the Pancreas: European Society Medical Oncology Clinical Practice Guidelines
    M Ducreux and others
    Annals of Oncology, 2015. Volume 26, Supplement 5, v56 to v68

Last reviewed: 
31 Mar 2023
Next review due: 
31 Mar 2026

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