Doctors found that the actor had a malignant tumor in his midsection, and a tiny mass on his liver. Pancreatic cancer is extremely difficult to diagnose, and only after a battery of procedures over several days were his doctors able to make a definitive diagnosis: stage 4 pancreatic cancer.
It fell to Niemi, 52, to break the news to her husband.
"It was very surreal," she said. "They were like 99 percent sure. And I know he was still a little dopey from the procedure and I could have told him then, and I said you know what, this is information he can do without for just a few hours, 'cause after he learns this, we can't go back. So I waited until the next morning to tell him about it, and for the first few weeks it was like being in a nightmare you couldn't wake up from."
Although the majority of patients with advanced stage pancreatic cancer die within six months of the diagnosis, Swayze reacted with defiance.
"I have the meanness and the passion to say, 'To hell with you. Watch me! You watch what I pull off.'"
Swayze wanted to keep the secret as long as possible while he and his wife decided how to proceed, but the news of his life-threatening illness broke early last year when tabloids reported he had only five weeks to live.
Swayze said he was able to ignore the tabloids in the past but began to feel differently "when they start screwing with people I love, when they start screwing with my family.
"Hope is a very, very fragile thing in anyone's life," he said, "and the people I love do not need to have that hope robbed from them, when it's unjustified and it's untrue."
Swayze categorically denied tabloid reports that the end is near. "Am I dying? Am I giving up? Am I on my deathbed? Am I saying goodbye to people? No way."
Dr. John Chabot, one of the country's leading pancreatic cancer researchers at New York-Presbyterian Hospital/The University Hospital of Columbia and Cornel, calls pancreatic cancer the silent killer because there are often few, if any, symptoms.
While Chabot said it's difficult to know what causes one individual's pancreatic cancer, he said that "smoking is the one thing that we know of that clearly, clearly, clearly increases the chance that somebody's gonna get pancreatic cancer."
Swayze has been a smoker for decades. He admitted to Walters that despite his diagnosis, "I am not a nonsmoker. I've seriously cut down." When pressed, he acknowledged, "I will go so far as to say probably smoking had something to do with my pancreatic cancer."
He said he hasn't quit yet because he does not believe it will change his prognosis. But he vows, "When it looks like I may live longer than five minutes? I'll drop cigarettes like a hot potato." For now, he said, "it's not my priority."
Swayze, who plays an FBI agent, was proud to say that "nobody on the set ever saw me whine, moan like a girly-loser-man. I would do an attitude adjustment every morning."
"I've always known that Patrick is a really tough guy, but until all this illness came up in this past year, I had no idea really, the depths of his toughness and, and the amount of fight in him," said Niemi.