If it is how you are describing it..and it isn't a misfire...then it sounds like it could be related to the HPOil system...
if the truck has a tuner or chip on it, remove it (or lower the setting to something mild)...see if that solves the issue.
A lot/all tuner & chips increase ICP pressure..and at steady pedal...you are most likely to have the on/off on/off surging as the computer/tuning overshoots and undershoots the desired ICP pressure.
you/he could verify this if he has a way of monitoring ICP pressure...either with a scan tool or a mechanical gauge.
if it is NOT tuning/chip related...then without a whole lot of diagnostics...I would first CHECK to see if the IPR nut has fallen off of, or is loose on the IPR valve in the back of the HPOP...
if IPR valve is intact/tight...then replace the IPR.
here's a link that will describe how to check ICP pressure...but disregard the WOT runs...and just watch the ICP pressure during steady state driving for pressure fluctuations.
http://www.swampsdiesel.com/site/how_to_pdf/pdf/hpop.pdf
if the IPR doesn't fix it..and you still have the pressure fluctuations..it can take much more indepth diagnostics to determine which other component(s) are causing the pressure spikes and the surge. As an injector (poppet valve), sticking, low pressure oil problem, HPOPump problem can (all) cause similar spikes in psi...even low oil level in the pan can cause these/similar issues