Was Alex a heavy smoker and drinker?
When I first heard that he had pancreatic cancer, I immediately thought about the likely causes. Michael Landon and Patrick Swayze were apparently huge smokers and drinkers leading up to getting pancreatic cancer themselves.
https://www.cancer.org/cancer/pancreatic-cancer/causes-risks-prevention/risk-factors.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956306/
http://pathology.jhu.edu/pc/BasicCauses.php?area=ba
https://www.cancernetwork.com/news/smoking-linked-worse-pancreatic-cancer-survival
https://www.cancercenter.com/cancer-types/pancreatic-cancer/risk-factors
https://www.cancer.net/cancer-types/pancreatic-cancer/risk-factors
http://columbiasurgery.org/pancreas/what-causes-pancreatic-cancer