Standard of Care Chemotherapy With or Without Stereotactic Body Radiation Therapy for Oligometastatic Pancreatic Cancer

Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1 or 2

Negative pregnancy test done =\< 7days prior to registration, for women of childbearing potential only

* NOTE: If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required

Ability to complete questionnaire(s) by themselves or with assistance

Provide written informed consent

Willing to return to enrolling institution for follow-up (during the Active Monitoring Phase of the study)

Willing to provide tissue and/or blood samples for correlative research purposes

Hemoglobin \>= 9.0 g/dL (obtained =\< 28 days prior to registration)

Absolute neutrophil count (ANC) \>= 1500/mm\^3 (obtained =\< 28 days prior to registration)

Platelet count \>= 100,000/mm\^3 (obtained =\< 28 days prior to registration)

Total bilirubin =\< 1.5 x upper limit of normal (ULN) (If known Gilbert's syndrome, then =\< 3.0 x ULN) (obtained =\< 28 days prior to registration)

Alanine aminotransferase (ALT) and aspartate transaminase (AST) =\< 3 x ULN (=\< 5 x ULN for patients with liver involvement) (obtained =\< 28 days prior to registration)

Prothrombin time (PT)/international normalized ratio (INR)/activated partial thromboplastin time (aPTT) =\< 1.5 x ULN OR if patient is receiving anticoagulant therapy and INR or aPTT is within target range of therapy (obtained =\< 28 days prior to registration)

Calculated creatinine clearance \>= 45 ml/min using the Cockcroft-Gault formula (obtained =\< 28 days prior to registration)

Pregnant women

Nursing women

Men or women of childbearing potential who are unwilling to employ adequate contraception

Any of the following prior therapies:

* Surgery =\< 3 weeks prior to registration

* Prior radiation to an overlapping area

Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens

Uncontrolled intercurrent illness including, but not limited to:

* Ongoing or active infection

* Symptomatic congestive heart failure

* Unstable angina pectoris

* Cardiac arrhythmia

* Or psychiatric illness/social situations that would limit compliance with study requirements

Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm

Other active malignancy =\< 1 year prior to registration

* EXCEPTIONS: Non-melanotic skin cancer or carcinoma-in-situ of the cervix

* NOTE: If there is a history of prior malignancy, they must not be receiving other specific treatment for their cancer

History of myocardial infarction =\< 6 months, or congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias

What this study is about