@davod , I'm also sorry to hear about your situation, but you deserve a real second opinion from OUTSIDE of KP. Institutional groupthink is rarely good. Most doctors and institutions are too self-absorbed to contradict their immediate colleagues or help patients look for trials outside their own walls.

It sounds like your oncologists at KP basically just dismissed you. If you're up for a fight, there are other treatment avenues and definitely other institutions to consider.

DISCLAIMER: I have no medical training, just 2.5 years experience as a PC patient, the last 16 months as a very healthy stage-4. With that said...

You didn't mention what type of pancreatic cancer you have (adenocarcinoma, acinar cell carcinoma, Squamous Cell Carcinoma, Adenosquamous Carcinoma, Colloid Carcinoma, neuroendocrine tumors (NETs)), how far the disease has spread, which other organs are definitely affected by metastases, what your CA19-9 levels are, etc... Your docs should have been very forthcoming with that info, which would help yourself and everyone else understand what treatment options and institutions might be worth considering.

You should start by immediately getting germline and somatic blood testing done to see if you have any DNA mutations that could be targeted by a specific drug. Feed the results of that ASAP to a patient advocate at pancan.org ; consider cancercommons.org as well, and see what you can find on your own at clinicaltrials.gov

There may be trials out there that are not as hard on your blood counts as the KP oncologists were thinking, and possibly even lower doses of traditional "monotherapy" that might benefit you and possibly buy you more than their anticipated 2-6 months. Although Folfirinox and standard doses of Gemcitabine + (Abraxane or Cisplatin) would likely be hard on you, any of the individual ingredients in those recipes might be life-extending candidates. Oral capecitabine (jokingly referred to as "Gemcitabine-Junior" in another thread here), or carboplatin (a more tolerable platinum agent than oxaliplatin or cisplatin) might be helpful.

A more "engaged" care team might be able to manage your blood counts with blood transfusions, Neulasta, epoetin, even possibly testosterone to raise hemoglobin and energy.

There are immunotherapy agents and targeted therapies that might be very manageable with your other conditions. My 84-year old father-in-law has had several heart attacks, congestive heart failure, and kidney cancer (+ nephrectomy -- removal of one kidney) to go along with dementia... and is doing surprisingly well after a rough start on his immunotherapy.

There are also numerous non-traditional therapies, depending on the extent/locations of your cancer, how far you can travel, how disqualifying your blood counts might be on a specific trial, and if cost is a major issue. Tumor Treatment Fields equipment has limited effect without an accompanying chemo drug, but virtually zero side effects. There are implantable chemo pumps that just deliver chemo locally in small doses to organs like the liver, without having such a huge impact on you systemically.

There are clinical trials going on for all sorts of "vaccines" from CAR T-cells to Natural Killer cells to "personalized peptide protocol" treatments (Canada/Germany, expensive and not easily researchable in the US).

Of course we all respect whatever decision you make, as long as it's truly YOUR decision and not one made based on bad or limited data. Wishing you the best! --mm