Steps to take after a metastatic pancreatic cancer diagnosis

Metastatic pancreatic cancer is cancer that began in the cells of the pancreas but has spread to another area of the body, such as lymph nodes, the liver, the lungs, the brain, bones, and other areas of the abdomen. Because pancreatic cancer often does not cause any symptoms in the early stages, most people are not diagnosed until the cancer has advanced beyond the early stages. Roughly half of people who have pancreatic cancer are metastatic at the time of diagnosis.

If you or a loved one has recently been diagnosed with metastatic pancreatic cancer, the following is an overview of the steps to take when working with your healthcare team.

Follow up with diagnostic tests

The diagnosis of metastatic pancreatic cancer is typically a multi-step process. Depending on where you are in this process, your healthcare providers may recommend additional tests to learn more about the cancer. Diagnosis may involve:

• A physical exam and medical history
• Referral to an oncologist and a gastroenterologist
• Imaging tests (such as MRIs, PET scans, X-rays, and others)
• Liver function tests and blood tests
• Tumor biopsies (tests that remove a sample of a tumor for testing in a lab)

Like other aspects of cancer care, the tools used during diagnosis will vary from person to person. The diagnostic tests you receive should help answer these questions about the cancer:

• What areas has the cancer spread to?
• What is the size of the tumors?
• What is the grade of the cancer cells? Grading determines how much the cancer cells have mutated, which is often an indicator of how malignant the tumors are and how quickly the cancer will spread.
• How aggressively is the cancer growing and spreading?

Get copies of your test results

You will want to get copies of your test results, pathology reports, and other documents regarding your diagnosis, treatment, and medical history. These will make the process much easier if you are referred to a different healthcare provider or if you seek a second opinion about the diagnosis.

Should you seek a second opinion?

When it comes to a major diagnosis such as cancer, it’s often recommended that a person seek a second opinion about the diagnosis. A second opinion is when a healthcare provider other than your current healthcare provider reviews and evaluates the results of your tests. Based on this review and evaluation, this provider will make their own treatment recommendations. Second opinions are not always necessary, but can have several benefits, such as more confidence in the diagnosis and awareness of additional treatment options.

Before seeking a second opinion, it's important to check with your insurance company about coverage.

Working with your healthcare team

Metastatic pancreatic cancer is not considered curable, and the goal of treatment is to ease symptoms and help a person live longer. The main treatment is chemotherapy or other systemic therapies (therapies that act on cancer cells throughout the body). Radiation and surgical procedures may be used to relieve specific symptoms caused by the cancer.

People with pancreatic cancer are encouraged to take an active role in treatment decisions. The term for this is shared decision making. Because each diagnosis of metastatic pancreatic cancer is unique, your healthcare team will be your best source of information. It also helps to spend time on your own learning about pancreatic cancer and how it can be treated.