Metastatic testicular cancer

Treatment Options for Testicular Cancer, by Type and Stag

Carcinoma in situ (stage 0) testicular tumors In this stage, the cancer has not spread outside the testicle, and tumor marker levels (like HCG and AFP) are not elevated. If CIS is diagnosed after surgery removes the testicle, no other treatment is needed When it spreads to distant areas, it is known as metastatic testicular cancer. There are specific areas of the body where metastatic testicular cancer is more likely to be found. One of the first areas is often the lymph nodes located closest to the testicles Metastasis (M) The M in the TNM system describes whether the cancer has spread to other parts of the body, called distant metastasis. When testicular cancer spreads, it most commonly spreads to the lung and the lymph nodes of the chest, pelvis, and the base of the neck. More advanced stages may have spread to the liver and bones Metastatic testicular cancer is cancer that has spread beyond the testicle to the rest of the body. Fortunately, testicular cancer is still highly curable even at this stage. In this article, I'll explain a little more about how testicular cancer spreads and the treatments that can be used. Tumor Type Is Importan

Testicular cancer occurs in the testicles (testes), which are located inside the scrotum, a loose bag of skin underneath the penis. The testicles produce male sex hormones and sperm for reproduction. Compared with other types of cancer, testicular cancer is rare Background: Existing data on the association of metastatic sites and prognosis of patients with metastatic testicular malignancy are limited. In this study, the association of survival outcome and the prognostic value of different metastatic sites in patients with metastatic testicular cancer was investigated Metastatic testicular cancer survivor: A positive attitude was everything for me. In 2001, I was 31 years old, working full time and engaged to be married. I had no symptoms or abnormalities. But one day, I noticed a knot on my left testicle. After going to see my doctor in Monroe, Louisiana, I was diagnosed with a rare form of testicular cancer Most often, the first symptom of testicular cancer is a lump on the testicle, or the testicle becomes swollen or larger. (It's normal for one testicle to be slightly larger than the other, and for one to hang lower than the other.) Some testicular tumors might cause pain, but most of the time they don't The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute (NCI), to provide survival statistics for different types of cancer. The SEER database tracks 5-year relative survival rates for testicular cancer in the United States, based on how far the cancer has spread

Testicular cancer is one of the few cancers associated with tumor markers. It is not clear why testicular cancers release these markers. Most testis cancers that secrete tumor markers are nonseminomatous germ cell tumors (NSGCT), and 85 percent of NSGCT will secrete at least one tumor marker When testicular cancer becomes metastatic, the most common sites are the lungs, and the lymph nodes in the chest, pelvis and neck. However, more advanced cases can metastasize to the liver or bone. If testicular cancer spreads to the bone, it is called testicular cancer bone mets. Testicular cancer bone met

A primary or metastatic malignant neoplasm involvingf the testis Testicular cancer forms in a man's testicles, the two egg-shaped glands that produce sperm and testosterone. Testicular cancer mainly affects young men between the ages of 20 and 39. It is also more common in men wh For testicular cancer, metastasis is most common in the lungs and lymph nodes in the chest, pelvis and base of the neck. Cancer that is more advanced can also spread to the bones or the liver. There are two main types of testicular cancer - seminomas and nonseminomas. Seminomas tend to grow and spread more slowly than nonseminomas, which are. Metastatic testicular cancer grows very rapidly and is uniquely curable with cisplatin combination chemotherapy. However, 2-3% of patients initially diagnosed with testicular cancer will experience a late relapse beyond 2 years of last therapy. Most late relapses occur beyond 5 years, with our latest relapse 32 years after chemotherapy

Metastatic cancer has the same name as the primary cancer. For example, breast cancer that spreads to the lung is called metastatic breast cancer, not lung cancer. It is treated as stage IV breast cancer, not as lung cancer. Sometimes when people are diagnosed with metastatic cancer, doctors cannot tell where it started The majority of testicular cancers start in germ cells. Germ cells in your testicles make sperm. When these cells begin to grow out of control, they form two main types of tumors: seminomas and.. Operations used to treat testicular cancer include: Surgery to remove your testicle (radical inguinal orchiectomy) is the primary treatment for nearly all stages and types of testicular cancer. To remove your testicle, your surgeon makes an incision in your groin and extracts the entire testicle through the opening Background: Testicular cancers are heterogenous neoplasms often found in young adults. They tend to metastasize to the chest, retroperitoneum, or neck, but rarely to the long bones or skeleton

Video: Where Does Testicular Cancer Spread To? Moffit

High-Dose Chemotherapy and Stem Cell Transplant for Testicular Cancer. In general, testicular cancers respond well to chemotherapy (chemo), but not all of them are cured. Even though higher doses of chemo might work better, they're not given because they could severely damage the bone marrow, which is where new blood cells form. This could lead. Testicular cancer is a chemotherapy-sensitive cancer that is a risk factor for the development of TLS. Attention must be paid to the potential risk of TLS in patients of advanced testicular cancer with balky metastasis Guidelines on testicular cancer European Association of Urology, 2021. Cancer Prinicples & Practice of Oncology (10th edition) V T DeVita, T S Lawrence and S A Rosenberg. Wolters Klumer 2015. Predicting Outcomes in Men With Metastatic Nonseminomatous Germ Cell Tumors (NSGCT): Results From the IGCCCG Update Consortium S. Gillessen and other

Testicular Cancer: Stages Cancer

Metastatic Pattern of Spread of Testicular Cancer. Introduction: There are a number of histologic types of testicular germ cell tumors, usually divided into seminomas and non-seminomatous germ cell tumors. Testicular cancer has the highest propensity for metastatic spread among all cancers. AJR Am J Roentgenol. 1985 Dec;145 (6):1165-71 1. Without the testicular US findings, the most likely differential diagnosis is lymphoma. 2. In the setting of a testicular mass, the most likely differential becomes metastatic testicular malignancy, particularly given the patient's age. 3. T.. Testicular cancer occurs when cells in the testicles grow and multiply uncontrollably, damaging surrounding tissue and interfering with the normal function of the testicle. If the disease spreads, it is still called testicular cancer. The testicles (also called testes) are a pair of male sex glands that are in a sac-like pouch (the scrotum. The earliest stage of testicular cancer is stage 0 (also called germ cell neoplasia in situ, or GCNIS). The other stage groupings range from I (1) through III (3). There is no stage IV (4) testicular cancer. Some stages are split further to cover more details, using capital letters (A, B, etc.)

Staging of testicular GCTs is based on determination of the extent of disease and assessment of postorchiectomy levels of serum tumor markers. 12 The tumor (T), node (N), and metastasis (M) staging system used by the AJCC is the internationally accepted standard for cancer staging and is a major factor influencing prognosis and treatment. Testicular Cancer Staging. The staging of testis cancer refers to how far the cancer has spread. Staging is determined with information from the orchiectomy, tumor markers (blood tests) and imaging studies. As the testicles form and develop near the kidneys in a fetus, the blood supply, lymphatic drainage and nerves to the testicle originate. The most common treatment for metastatic testicular cancer is surgery followed by a chemotherapy combina­tion of bleomycin, etoposide and cisplatin. This powerful combination routinely produces all the harsh side effects associated with chemotherapy, but it can also lead to a litany of long-term side effects: infertility, low testosterone. Chemotherapy (chemo) is the use of drugs to treat cancer. The drugs can be swallowed in pill form, or they can be injected by needle into a vein or muscle. To treat testicular cancer , the drugs are usually given into a vein (IV). Chemo is systemic therapy. This means that the drug travels throughout the body to reach and destroy the cancer cells

A Large Intra-Abdominal Mass in a 29-Year Old Man With a

Metastatic Testicular Cancer - What is it and Can You Be

Testicular cancer begins in your testes, the male reproductive organ. Which treatment your doctor will choose to treat it is based on the type of cancer you have and if it has spread.. The. Testicular cancer is a rare malignancy, with only about 8,000 cases diagnosed in the United States each year. When the disease does strike, however, it can be highly aggressive. About two-thirds of patients are first diagnosed with disease that has spread, or metastasized

Colorectal Surgery: What To Expect From Your Bowel Cancer

Testicular cancer - Symptoms and causes - Mayo Clini

  1. Testicular Cancer Working in retail takes a person with an outgoing personality and a commitment to customer service. I really like the pace of working in the store, says Andrew Steinmetz, 23, who is a manager at a business supply store in Philadelphia
  2. Metastatic testicular cancer. If cancer has spread to another location in the body, it is called metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option
  3. In addition, the new data show that the prognosis for patients with metastatic testicular cancer has improved significantly over the past twenty years. Testicular cancer is the most common cancer.

Frontiers Prognosis of Patients With Testicular

  1. Testicular metastasis from cancer of the digestive tract is a rare or even exceptional eventuality, as conventionally three organs can be affected, especially the omental lymph node chains, the peritoneum and the liver [8]. The incidence of testicular metastases is estimated at 2.5% according to various series of autopsies
  2. Epidemiology. Metastases to the testes are apparent in ~0.04% of autopsy studies in patients with known malignancy. The average age is 57 years, much older than the primary age for primary testicular cancer 2.. Pathology. The literature suggests that the rarity of metastases to the testes may be due to
  3. Abstract. Introduction of the chemotherapeutic agent cisplatin in 1974 initiated 15 years of progress in the management of metastatic testicular cancer at a pace virtually unprecedented in the history of medical oncology. With current cisplatin- and etoposide-based regimens, longterm survival of 80% is consistently achieved
  4. Testicular cancer is cancer that develops in the testicles, a part of the male reproductive system. Symptoms may include a lump in the testicle, or swelling or pain in the scrotum. Treatment may result in infertility.. Risk factors include an undescended testis, family history of the disease, and previous history of testicular cancer. The most common type is germ cell tumors which are divided.
  5. Testicular cancer is one of the most commonly diagnosed cancers in young adult men, particularly between ages 30 to 39. In 2020, there were an estimated 3,100 new cases of the disease in the 30 to 39 age group and 3,000 new cases in the 20 to 29 age group. The average age of diagnosis is 33
  6. Spine metastasis from testicular cancer is rare, accounting for less than one percent of cases in several large series 4, 7, 8, 11, 13, 21, 24. The most common presenting symptoms of spine metastases are back pain, motor weakness, and sensory disturbance [ 1 , 2 , 4 , 7 , 8 , 13 , 18 , 20 , 24 ,37]
  7. Testicular cancer metastasis to soft tissue, including the trunk, and extremities, appears to be exceedingly rare, as reflected in the extremely limited number of published cases , , , , . A systematic review of the literature over the past 35 years found a total of seven cases of soft tissue metastasis from primary testicular cancer

Metastatic testicular cancer survivor: A positive attitude

PURPOSE Despite improved cure rates for patients with metastatic testicular cancer with cisplatin-based combination chemotherapy, patients who develop brain metastases are generally considered to possess a poor prognosis. This report summarizes the long-term results in 44 patients with brain metastases from testicular cancer treated between 1978 and 1995 at Hannover University Medical School. In addition, brain MRIs are often recommended for poor-risk metastatic testicular cancer (see Stages) with very high serum tumor markers or if the cancer has spread to the liver, to the bones, or extensively to the lungs. Your doctor will explain which test is appropriate for you. PET scan. PET scans are not generally used for testicular cancer

Testicular Cancer Signs and Symptoms American Cancer Societ

  1. Testicular cancer is the most common cancer in young men between the ages of 15 and 35. Just over 40 years ago, the great majority of patients with metastatic testicular cancer died within one year of diagnosis. Today, an even larger majority of patients with metastatic testicular cancer are completely cured of their disease
  2. omas and non-se
  3. oma residual lesions: a retrospective validation of the SEMPET trial
  4. Initial presentation of a malignant testicular tumour with a neck lump is unusual as the most common presentation for a germ cell testicular cancer is a painless testicular enlargement.5-7 Among patients with testicular cancer, the incidence of neck nodal metastases is between 4.5% and 15% and only 5% of these have a neck mass as the initial.
  5. The primary treatment for testicular cancer is the removal of the affected testicle. However, the disease is often only discovered at a stage where metastases are already present and then, after.
  6. Testicular cancer represents the most common nonhematologic malignancy in men between 15 and 49 years old [].Although the disease is relatively uncommon, the incidence has more than doubled over the past four decades [2, 3].In 2012, 8590 new diagnoses will be made and 360 deaths are expected to occur among men in the United States

CACI - Testicular Cancer Worksheet (Updated 8/26/15) The Examiner must review a current status report by the treating physician and any supporting documents to determine the applicant's eligibility for certification. If the applicant meets ALL the acceptable certification criteria listed below, the Examiner can issue Brain metastases may form one tumor or many tumors in the brain. As the metastatic brain tumors grow, they create pressure on and change the function of surrounding brain tissue. This causes signs and symptoms, such as headache, personality changes, memory loss and seizures. Treatment for people whose cancer has spread to the brain may include. Testicular cancer staging is based on local tumor extent, presence and size of regional nodes, serum tumor marker levels, and distant metastases (see Table 6.3) [].Local disease is divided as limited to testis and epididymis (T1), involving testis and epididymis with vascular/lymphatic invasion or tumor extension through the tunica albuginea to tunica vaginalis (T2), tumor invading spermatic. Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles. The testicles are 2 egg-shaped glands located inside the scrotum (a sac of loose skin that lies directly below the penis).The testicles are held within the scrotum by the spermatic cord, which also contains the vas deferens and vessels and nerves of the testicles Testicular cancer consists of two general groups: seminomatous and nonseminomatous testicular cancers. Very much as in staging of other tumors, fluorodeoxyglucose (FDG) positron emission tomography (PET) of testicular cancer results in the detection of local and distant metastases and may allow for a more accurate staging than morphologic imaging modalities (see Fig. 48.1)

The American Cancer Society estimated that 8820 new cases of testicular cancer would be diagnosed in the United States in 2014 but that only about 380 individuals would die of the disease ().Testicular cancer is the most common tumor in young adult men (), and the majority of cases occur in young men aged 15-35 (1,4).Radiologists play an important role in identifying the primary tumor. This is also called metastatic testicular cancer. One or more tumour marker levels are moderately higher than normal. Stage 3C. Any of the following: The cancer has spread to lymph nodes in the groin, and 1 or more tumour marker levels are much higher than normal Testicular Cancer Treatment Regimens. Clinical Trials: The NCCN recommends cancer patient participation in clinical trials as the gold standard for treatment. Cancer therapy selection, dosing. 96.5% of males survive testicular cancer for at least one year, this remains similar at 95.3% surviving for five years or more, as shown by age-standardised net survival for patients diagnosed with testicular cancer during 2013-2017 in England.[]Testicular Cancer Age-Standardised One-, Five- and Ten-Year Net Survival, Adults (Aged 15-99), England, 2013-201

Testicular Cancer Survival Rates Testicular Cancer Prognosi

  1. Cancer that spreads from its place of origin to other regions of the body is called metastatic cancer and the process is called metastasis, the plural of which is metastases. It is referred to as stage 4 cancer. Metastasis is defined as the formation of secondary and tertiary tumors in body tissues and organs away from the primary cancer site
  2. Testicular cancer with neurological symptoms indicates brain metastases. A 25-year-old man presented to our emergency room with a sudden onset of a pulsatile headache and blurred vision. He also reported a 9-day history of a swelling in his scrotum following trauma. He had no medical history
  3. Testicular cancer, bilateral testis ICD-10-CM C62.92 is grouped within Diagnostic Related Group(s) (MS-DRG v 38.0): 715 Other male reproductive system o.r. Procedures for malignancy with cc/mc
  4. Other authors have speculated about metastases containing immature germ cells being able to differentiate into mature teratomas independent of the therapy instituted [23]. Mature teratomas have been found during histologic analyses of the excised metastases of testicular cancer, but their incidence differs from one center to the other [18,24, 251
  5. oma, non-se
  6. 13.25 Testicles— cancer with metastatic disease progressive or recurrent following initial chemotherapy. 13.26 Penis -carcinoma with metastases to or beyond the regional lymph nodes. 13.27 Primary site unknown after appropriate search for primary —metastatic carcinoma or sarcoma, except for squamous cell carcinoma confined to the neck nodes
  7. Primary testicular tumors are the most common solid malignant tumor in men between the ages of 20 and 35 years in the United States. For unknown reasons, the incidence of this cancer increased during the last century

Testicular germ cell tumors (TGCTs) are a cancer pharmacology success story with a majority of patients cured even in the highly advanced and metastatic setting. Successful treatment of TGCTs is primarily due to the exquisite responsiveness of this solid tumor to cisplatin-based therapy Patients with testicular cancer or lymphoma, however, have a higher likelihood of long-term survival and cure compared with those with most other cancers. In some circumstances in which the primary tumor has been removed and cancer has spread to only limited areas of the lung, the lung metastases can be removed surgically with the goal of long. CT is the primary imaging modality for disease staging in testicular cancer patients for disease in the neck, thorax, abdomen, and pelvis, with accuracy close to 80%. 72 Approximately 38% of testicular cancer patients present with retroperitoneal metastases at the time of initial diagnosis, and CT is a sensitive modality for detecting the. Reveal what all men need to know about testicular cancer and symptoms today

Testicular metastasis from cancer of the digestive tract is a rare or even exceptional eventuality, as conventionally three organs can be affected, especially the omental lymph node chains, the peritoneum and the liver [8]. The incidence of testicular metastases is estimated at 2.5% according to various series of autopsies Testicular cancer that has spread (metastasized) to organs other than the lungs usually has a poor prognosis. Where the cancer has spread is the main prognostic factor for seminomas. Doctors will also consider where non-seminomas spread, but other prognostic factors (such as where it started and the level of tumour markers) are also important.

343. Background: Metastasis of testicular germ cell tumour (GCT) to bone is a rare event and there is little evidence on optimal curative management. Methods: A retrospective review of case records of germ cell tumour patients within the Anglian Germ Cell Cancer Group between 10/01/2005 and 14/03/2011 was conducted. Results: 2,550 cases of testicular germ cell tumour were reviewed and 19. Testicular tumors rarely happen in boys before puberty. The odds of a boy having a testicular tumor are about 1 in 100,000. In infants and boys, testicular tumors make up about 1 to 2% of all tumors. On the other hand, testicular cancer is the most common cancer in young men 15 to 34 years old Testicular liposarcoma is a very uncommon pathology associated with testicular cancer.1 Paratesticular soft tissue tumors are rare entities with malignant subtypes accounting for 30% of cases.2 Often misdiagnosed, testicular liposarcoma must be considered in the differential diagnosis of a groin mass.1 There are only few cases of the giant testicular liposarcoma of more than 10cm reported in. The most advanced stage of any types of cancers is stage 4 metastatic cancer. Stage 4 cancer of any kind is hard to treat. This still means that there is a chance for curing. There are many clinical trials that are improving that contribute in the increase of survival rates of patients. However, the improvemen TCAF's Financial Assistance Program is for families who are currently undergoing treatment for testicular cancer. Please see eligibility requirements below before filling out your application. Financial Assistance Grant Applications have two parts. If you are approved for part two of the application, depending on when you submit part two of the.

Penile metastasis from testicular cancer is a rare condition. To our knowledge, only 11 cases have been described in literature. Patients with non-pulmonary visceral metastases should be considered . poor risk, based on the International Germ Cell Cancer Collaborative Group classification. It is debated whether penis lesion is a visceral site Testicular cancer can develop in one or both testicles. Most tumors are metastatic, meaning they have the ability to spread to other organs, such as the lymph system, lungs and brain, leading to serious illness or death. If found and treated early, testicular cancer is up to 99% curable

Video: Testicular Cancer Tumor Markers Johns Hopkins Medicin

A Precision Treatment for Testicular Cancer Bone Mets

Follow the CACI - Testicular Cancer Worksheet (PDF) Note in Block 60. C. Metastatic disease. Current OR anytime in the past. Recurrence of disease. Submit the following to the FAA review: ☐ Current status report from oncologist describing treatment plan and prognosis; ☐ List of medications with attention to any chemotherapy agents and dates. Testicular cancer is a disease that occurs when cancerous (malignant) cells develop in the tissues of a testicle. The development of cancerous cells in both testicles can occur, but is very rare. Testicular cancer is the most common cancer in men aged 20 to 35. The disease usually is curable

Pathology Outlines - Metastastic tumors to lung

2021 ICD-10-CM Codes C62*: Malignant neoplasm of testi

5.7 Diagnosis and treatment of testicular intraepithelial neoplasia (TIN) 14 5.8 Screening 14 5.9 Guidelines for the diagnosis and staging of testicular cancer 14 6. PROGNOSIS 15 6.1 Risk factors for metastatic relapse in stage I GCT 15 7. DISEASE MANAGEMENT 15 7.1 Impact on fertility and fertility-associated issues 1 Testicular cancer is the role model of a curable cancer. About 10% of patients initially present with advanced disease and tumor spread to the lungs. However, even with adverse prognostic parameters these patients experience an impressive survival if treated by a multimodality management of chemotherapy and surgery [1]

Male GU Lecture 1 - Testis at University Of FloridaTESTICULAR CANCERS

Does Testicular Cancer Spread Quickly? Moffit

Most solid tumor cancer types are virtually incurable once they have spread from their primary site. Fortunately for Armstrong—and anyone else who has experienced metastatic testicular cancer—testicular cancer is one of the most curable solid tumor cancers even when it has spread well beyond its original site.  The staging for testicular tumors is performed according to the TNM system with staging groupings. It can be remembered in its abbreviated form as: stage I: confined to testis, epididymis, spermatic cord, scrotum; stage II: lymph nodes involved but no distant metastases and serum tumor markers are not very high; stage III: distant metastases or moderately high serum tumor marker Testicular germ cell cancer is the most common malignancy in men aged 15-44 years [], with non-seminomatous germ cell tumors (NSGCTs) diagnosed in 40% of the cases [].Approximately 70% of them. Introduction. Testicular cancer is a relatively rare tumor type accounting for approximately 1% of all male cancers globally. 1 However, testicular cancer has a very distinctive age distribution and in many developed countries it is the most commonly diagnosed malignancy among men aged between 15-40 years. 2 In recent decades, the incidence of testicular cancer has been increasing, with a. A testicular cancer survey was carried out by the Japanese Urological Association in 2011 to register newly diagnosed testicular cancers in 2005 and 2008. Among 1121 registered patients, 278 patients with metastases who received chemotherapy as the initial treatment and could be categorized by the Japanese Urological Association classification.

Curing metastatic testicular cancer PNA

The model was tested against 49 patients with metastatic testicular cancer treated at the University of Minnesota Hospitals, and it correctly predicted 86% of complete remissions and 84% of all outcomes. In a highly curable disease such as testicular cancer, mathematical modeling may enable the clinical investigator to anticipate those patients. Teratoma. Teratomas are germ cell tumors that when seen under the microscope, look like each of the three layers of a developing embryo: endoderm (inner layer), mesoderm (middle layer) and ectoderm (outer layer). There are three types of Teratoma Tumors. Mature teratomas are tumors formed by cells similar to cells of adult tissues.They are generally benign and rarely spread to nearby tissues. Neuroendocrine Tumors Non-Small Cell Lung Cancer - Early and Locally Advanced Non-Small Cell Lung Cancer - Metastatic Ovarian Cancer Pancreatic Cancer Primary Cutaneous Lymphomas Prostate Cancer: Testicular Cancer. Version: 2.2021 Thymomas and Thymic Carcinomas. Version: 1.2021 Thyroid Carcinoma.

Testicular tumour - Radiology at StTesticular Cancer Imaging | Radiology Keygerminoma - HumpathMedical Treatment of Advanced Testicular Cancer | Oncology

Purpose: Testicular teratomas in adult patients are histologically diverse tumors that frequently coexist with other germ cell tumor (GCT) components. These mixed GCTs often metastasize to retroperitoneal lymph nodes where multiple GCT elements are frequently present in the same metastatic lesion. Neither the genetic relationships among the different components in metastatic lesions nor the. a. Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for testicular cancer in men if they have a non‑painful enlargement or change in shape or texture of the testis. b. Consider a direct access ultrasound scan for testicular cancer in men with unexplained or persistent testicular symptoms Future Research. Twenty years after successful treatment for testicular cancer, survivors are at significantly increased risk of second malignant neoplasms and cardiovascular disease (CVD), according to what Dutch researchers say is the first large study to look at the long-term treatment-specific risks for these events in such patients. Figure. Over the last 40 years, there has been a significant increase in the incidence of testicular cancer. The epidemiologic evidence to understand this phenomenon is unclear, however exogenous estrogen exposure is thought to be a driver in the development of testicular cancer. This is of particular importance in the transgender population because utilization of exogenous estrogen therapy is an. Pancreatic cancer is considered stage IV or metastatic if it has spread to distant locations in the body, such as the liver, lungs, or adjacent organs including the stomach, spleen, and/or the bowel. Sometimes it can only be determined that a pancreatic cancer is in stage IV once surgery is completed