When Alex Trebek announced that he had stage 4 pancreatic cancer in March 2019, he didn’t miss a day of work despite battling the frequently brutal effects of chemotherapy. (Since Jeopardy! began in 1984, Trebek hosted more than 8,000 episodes.) “I plan to beat the low survival rate statistics for this disease. Truth told, I have to. Because under the terms of my contract, I have to host Jeopardy! for three more years,” Trebek said.

Fans immediately reacted with shock and support, sending cards, Tweets, holy water, prayer shawls and even cannabis. Trebek told journalists he felt extremely lucky for their good thoughts, positive energy, and prayers. "After you’re dead, people say, ‘Oh, he was such a good guy, we really liked him.’ But I am getting all that before that event. It makes me feel really, really good,” he's said.

Trebek jokes that having stage 4 cancer sounds 'impressive' and 'advanced'

Trebek initially blamed his stomach pain for several months on indigestion. When he finally went in for testing, doctors found a tumor the size of a small fist in his pancreas and diagnosed him with stage 4 pancreatic cancer, the most advanced stage. “It sounds impressive – I've got stage 4 cancer, okay? Not stage 1, for sissies, that's just beginner's cancer. I've got advanced!" Trebek said in an interview with Jane Pauley on CBS This Morning in mid-May.

Cancer of the pancreas is one of the deadliest forms of the disease. Only about nine percent of patients who are diagnosed with pancreatic cancer survive for five years, according to the American Cancer Society (ACS), although survival rates vary depending on many factors including the stage of cancer and whether it comes back following treatment. The ACS also estimates that about one in 64 Americans are diagnosed with pancreatic cancer in their lifetime, and nearly all patients are over the age of 45 at the time of diagnosis. Trebek was 78 when he was diagnosed.

The game show host said in interviews that he recognizes the chances of survival are “very, very low,” but he's not worried about dying — just the effect it would have on his loved ones, including his wife of 29 years, Jean Currivan, and his two adult children, Matthew and Emily. “[They] look at me as Mr. Strong, and if anybody’s going to beat this, Dad will. They’re very positive,” he told People.

Chemotherapy made the talk show host depressed

Trebek appeared on Good Morning America in May 2019 to discuss his cancer diagnosis and his struggle against depression during chemotherapy. He said he often felt down the day after treatment and managing his cancer caused “surges of deep, deep sadness” that brought him to tears: “Chemo affects people in different ways…There is nothing wrong with saying, ‘Hey, I am really depressed today and I have no idea why. Why am I crying today?’”

Chemo also caused Trebek to lose his hair and sense of taste, and suffer agonizing stomach cramps — which he described as jumping from a three to an 11 on the pain scale — while taping Jeopardy!.

Despite the challenges, Trebek said he tried to take things in stride, joking with nurses during chemo. Jeopardy! executive producer Harry Friedman told People that Trebek’s stoicism is real and “shows everyone who he is.”

Trebek's had 'mind-boggling' results from the chemo

In mid-May 2019, Trebek’s oncologists told him that he was responding extremely well to chemotherapy. "It's kind of mind-boggling. ... The doctors said they hadn't seen this kind of positive result in their memory ... some of the tumors have already shrunk by more than 50 percent," Trebek said.

Since his diagnosis, Trebek used his platform to raise awareness about the disease and money for pancreatic cancer research, even speaking at the Pancreatic Cancer Action Network’s PurpleStride walk to end pancreatic cancer in Los Angeles in May 2019. “If I’m going to be the public spokesperson for pancreatic cancer, my message is this: ‘Let’s be positive,’” he told People.

After a setback, Trebek admitted he's 'not afraid of dying'

In September 2019, Trebek revealed he was ordered for another round of chemo. “I was doing so well. And my numbers went down to the equivalent of a normal human being who does not have pancreatic cancer. So we were all very optimistic. And they said, 'Good, we're gonna stop chemo, we'll start you on immunotherapy,'" he told Good Morning America. "I lost about 12 pounds in a week. And my numbers went sky high, much higher than they were when I was first diagnosed. So, the doctors have decided that I have to undergo chemo again and that's what I'm doing."

He gave another update in October 2019, telling CTV News, "I’m not afraid of dying. I’ve lived a good life, a full life, and I’m nearing the end of that life … if it happens, why should I be afraid of that?"

In March 2020, Trebek announced he exceeded the average one-year survival rate for stage 4 pancreatic cancer. "Now I'd be lying if I said the journey had been an easy one," he said. "There were some good days but a lot of not-so-good days. I joked with friends that the cancer won't kill me; the chemo treatments will."

He continued, "If we take it one day at a time with a positive attitude, anything is possible."

Trebek sadly passed away from the disease on November 8, 2020.