Dear AW - I am just so sorry to hear about your brother! My son was also Stage 2 SCC, he had no job, no insurance, had recently been hospitalized for suicidal depression, recently divorced. But things really turned around for him. The hospital he was at had programs for people in dire financial straights and set up a program where we could pay very low amounts each month. He did go bankrupt but bankruptcy is survivable. There is also Social Security disability which my son did not get but I've heard of others being approved for it. There was also a drug program at the hospital he was at which forgave some of the most expensive drugs. Does your brother not have family or friends close by to lend support? How does he know "it is too big, it must have spread" unless he gets it looked at? Of course, as others have said, it is your brother's decision, but hopefully it will be an informed decision. My heart goes out to you and your brother and all those who are close to him.