I do have lesions on my liver in addition to the main tumor in the body of my pancreas. I probably have lesions elsewhere, for that matter. The lesions don't show up on a CT scan because they're too flat, but the surgeon saw them during my staging laparoscopy. So that makes me a stage 4. I'm not a medical professional, so all I can share is my own experience. In my case, chemo is not only the treatment of choice, it's the only treatment. The lesions and blood vessel involvement around the main tumor exclude me from any sort of surgery (such as the Whipple) or radiation. I did ask about HIPEC, which is a heated abdominal chemo wash, but my MD told me it would make me really sick and he didn't recommend it. I'm having chemo round 20 tomorrow. I'm on modified Folfiri (no oxaliplatin; my MD discontinued it after round 8), and my dosage level is lower than typical because of the side effects I had during round 1. Does that info help at all? Post your questions. There are a lot of really knowledgeable, helpful people on this board!