Man ... to be at that level of cachexia, plus the very not-good appearance of his beard and the slight redness on the upper prominence of his cheekbone (due to the loss of clotting factor production) ... all of it pretty much confirms that he's either in end-stage cancer, or is undergoing absolutely mind-blowing chemo regimes (the latter of which isn't out of the question; we can keep just about anything alive these days, at a price -- both financial and physical).
He's a raging asshole and quite possibly a sociopath, but pancreatic cancer -- any cancer -- is a terrible thing and no one should ever have to fight it.