Stage IV is the final stage of pancreatic cancer. It is indicated by the spread of cancer to distant sites, according to Texas Oncology, and it is characterized by involvement of the lungs, liver or adjacent organs such as the spleen or stomach or may spread to the bowel.
Stage IV pancreatic cancer is usually only classified as such following the completion of surgery. This stage of cancer can be further divided into two groups: stage IVA and stage IVB. Stage IVA pancreatic cancer is confined locally but involves adjacent blood vessels or organs, so its location hinders surgical removal. Other terms used for stage IVA pancreatic cancer include locally advanced or localized pancreatic cancer. By contrast, stage IVB pancreatic cancer has spread to distant organs beyond the pancreas; this stage most typically involves the liver. Stage IVB pancreatic cancer is metastatic cancer, according to Texas Oncology.
Treatment approaches for stage IVA and stage IVB pancreatic cancers vary by patient, but most stage IVA pancreatic cancer is treated by inducing remission, while stage IVB treatment plans generally only look to control symptoms and pain. Most stage IV pancreatic tumors cannot be removed surgically. For this reason, Texas Oncology states that pancreatic cancer at this stage is rarely curable and usually hard to control.