What does it mean to have stage IV cancer?

Staging is a process by which we determine the extent of spread of a cancer. There are 4 stages: stage I is an early stage in which the disease is limited to the organ of origin: in stage IV the cancer spreads or metastasize away from the organ origin of disease to other parts of the body, it is an advance stage of the cancer.

What exactly is pancreatic cancer?

Pancreas is a large leaf-like gland which is located in the upper part of abdomen below the stomach and surrounded in part by a segment of small bowel called duodenum. It secretes enzymes which participates in the digestion of food. It also secretes hormones like insulin which controls the level of sugar in the blood. Cancers originating in the pancreas are called pancreatic cancers.

How does it affect the body?

It depends on the location, size and the spread of the cancer. In the early stages, it may not cause any symptoms, and that’s why these cancers are usually not diagnosed until the are already in advanced stage. Cancer of the pancreas, in general, causes loss of appetite and loss of weight. These effects cause the body to get weaker and the patient to feel fatigued.

What could the patient be feeling with regard to symptoms?

Early symptoms are loss of appetite and loss of weight. Other symptoms can be weakness and fatigue, nausea and vomiting.

Late symptoms include jaundice due to obstruction to the flow of bile and pain in the upper abdomen which can be referred to back 

What do you think Mr. Trebek’s prognosis is? Why?

In general, the prognosis is poor with stage IV pancreatic cancer. The reason is that it is very aggressive disease and currently we do not have any good treatment for advance stages.

What is suggested treatment at this stage?  

Since the cancer has spread different parts of the body local treatments like surgery and radiation do not work. We have to use treatments which reach all the sites where cancer has spread. Anti-cancer drugs called chemotherapy are the treatment of choice. Depending on the physical condition of the patient, one drug or a combination 2 or more drugs can be used. The goal of treatment is not to cure but to control the disease.

What are the survival odds for this type of cancer?

In general, survival from any cancer is measured in terms of five-year survival rate. In stage IV pancreatic cancer it is about 3%.

How does one get tested for this type of cancer?

There is no screening test for early detection of pancreatic cancers, and therefore, by the time it is diagnosed pancreatic cancer is already in advance stage.

Testing done for the diagnosis and confirmation of these cancers can include blood tests, CT, MRI and PET scans. A biopsy has to be done to confirm the diagnosis.

Anything else you can tell us about this kind of cancer, treatment, etc.?

There is no screening test for early detection of cancer of pancreas, but life style changes like smoking cessation, exercise, healthy weight and diet rich in fresh fruits and vegetables can help to reduce the risk of developing these cancers.