Stage 4 Pancreatic Cancer: A Few Things We Learned the Hard Way
**My Father’s Stage 4 Pancreatic Cancer — Treatment & Symptom Management**
**Diagnosis**
Diagnosed with **Stage 4 pancreatic adenocarcinoma in April 2025**.
**Chemotherapy history**
Completed **12 cycles of FOLFIRINOX/FOLFIRI**.
Due to **disease progression**, treatment was changed to **Gemcitabine**.
Completed **6 cycles of Gemcitabine** before/after the change from FOLFIRINOX, as advised by his oncology team.
**Body Pain**
In our experience, there have been **two main possible reasons for his body pain**:
**Cancer/tumor-related pain**
**Significant loss of body weight and muscle mass**
**Pain medication**
Initially, doctors prescribed **Ultracet** for pain relief, usually **2–3 times a day as needed**.
Later, it was advised to use it **SOS (as required)**.
Pain management should be reviewed regularly with the treating doctor, especially if the pain is increasing or becoming difficult to control.
**Appetite, Digestion & Diarrhoea**
**Poor appetite and diarrhoea** can occur during chemotherapy and may also be related to **insufficient pancreatic digestive enzymes**.
Because the pancreas is affected by the cancer, the body may not produce enough enzymes to properly digest food.
Doctors may prescribe **Creon (pancreatic enzyme replacement therapy)** to help with digestion and absorption of nutrients.
In our experience, **Creon was sometimes prescribed late or not discussed during consultations**, so it may be worth specifically asking the treating oncologist/gastroenterologist whether pancreatic enzyme replacement is appropriate.
During follow-ups, it can be useful to discuss:
Appetite and food intake
Weight loss
Frequency/appearance of stools
Diarrhoea or oily/floating stools
Whether Creon is needed and whether the dose/timing is appropriate
**Important**
This is based on **our experience and should not replace the treating oncologist’s advice**.
In Stage 4 pancreatic cancer, **pain, weight loss, appetite, diarrhoea and digestion should all be actively discussed at every follow-up**, as they can significantly affect quality of life and nutrition.