As @gamaryanne and @markymarkfl suggest, clinical trials should be explored. If he is being treated at a comprehensive cancer center, surgical tumor tissue was likely sent for molecular profiling using Next Generation Sequencing. It is used to determine if somatic (spontaneous/sporadic) mutations and actionable biomarkers exist that can be matched to a clinical trial. If none are found, there is another category of trials using small molecule drugs targeting various cell functions that all patients are potentially eligible for.

In 2012 It was detected seven days after my Whipple that I had metastatic disease to the liver. So cure was no longer attainable by the Whipple. I was single and had responsibilities for caring for a house, paying a mortgage, and in the middle of a very contentious legal battle with a home construction contractor who I had to counter-sue. It was constant stress, aggregation and anxiety as the legal costs were $238K plus having to higher another contractor to correct mistakes and finish the job costing $110k. It took 5 years, seven months and $348K to win the case for which I received payment covering legal fees and the court judgment.

I was now fighting two major battles simultaneously. I took a few deep breaths, meditated and cleared my head and then set about formulating an action plan to deal with all the adversity and challenges. I wasn’t going to let my investment in going through Whipple surgery and post surgical treatment go in vain. The decision was made…this set-back would be dealt with. First I advocated for more aggressive chemo, then genetic testing was done detecting a mutation. That was helpful in searching for a clinical trial that took 14 months to find.

Treatment was every 15 days requiring commuting by train and subway requiring a 4 hour 20 minute train, subway and walking commute. I had this same daily commute as I worked all through my chemo treatment that was given at the same place I worked in clinical cancer research. My care team never told me what my estimated survival was. I never asked and they never volunteered. Years I got the courage to ask and was told 12 months with chemo.

When my chemo started, convention wisdom was cure was not possible by chemo and I was initially put on palliative care. That’s when I started my advocacy to change who patients are perceived and treated. Not only did I achieve No Evidence of Disease at the end of 24 months of chemo, I enrolled in a trial for maintenance monotherapy which is an oral tablet with no debilitating side effects. I am a 12 year survivor that is thriving. I feel as good as I did before onset of illness and thriving.

everything is not easy in life. I learned to deal with adversity and the challenges I faced. I didn’t fear treatments which were well managed by my care team with anti-emetics and anti-diahhreals that I took proactively rather than waiting for the onset of symptoms.This approach made it easier getting through treatment.

Hopefully you can convince your friend to do a reset on his outlook and understand this set-back can be overcome.There are options. I remember walking to the medical center from the subway every day for my work as well as chemo. I encountered people also going to the medical center who were in horrific accidents, patients that were quadriplegic or had lost limbs, were bling or suffering from ALS. I would look at them and think…they did give up. I had it better than them and I had stage IV pancreatic cancer. Those patients inspired me with hope and a will to live.I learned to practice gratitude and thankful for everyone on my care team and every day opening my eyes, getting out of bed and being productive.

One never knows how strong they are until strong is the only option.