So many approaches, my husband's metastasis 6 months after the 14 hour surgery wasn't responding well to the chemo. Due to the many mutations he qualified for immunotherapy Keytruda which zapped the visible 2 months metastasis on both of the adrenals . Unusual that Pan C. qualifies for that but after 2 years on it with .no recurrences and an improved quality of ife, he had to stop due to side effects. Now off of it for 1.5 years no visible recurrence . We just rejoice in one day at a time. but cancer is clearly an ongoing trip, especially P. C. Dealing with food absorption inadequacies is the big issue and fatigue is the daily issue.