Due to pancreatic cancer's dismal prognosis, much of management is focused upon palliation and symptom management, and the decision to treat a patient with more aggressive maneuvers must always take into account the impact upon a patient's quality of life. In addition, majority of the patients with advanced pancreatic cancer are elderly. Oncologists are challenged to make tough treatment decisions. Many elderly patients cannot tolerate side effects of chemotherapy, especially the combination regimens. Despite that many patients continue to receive chemotherapy even in the last month of their lives. The effect of referral to palliative care on health-related outcome especially for patients with poor quality of life is still not very clear. The authors will review abstracts that have focused on these fields that were presented at the Annual Meeting of ASCO 2013 (Abstracts #4009, #4053, #6607, #9518, #9538, #9539, #9546, and #9638).