Stage 4 Cancer Patients Share Survival Stories with Advanced Therapies

Three patients with advanced stage 4 cancers have shared their journeys, showcasing how targeted therapies, chemotherapy, and immunotherapy can impact survival and quality of life.

Dave Nitsche, a 49-year-old triathlete, was diagnosed with stage 4 lung cancer in late 2019 after experiencing vision loss. The cancer had metastasized to his eye, bones, liver, kidneys, and brain. He had never smoked and had no family history of lung cancer. His initial prognosis was a 1- to 2-year life expectancy. Traditional treatments like chemotherapy or radiation were not an option due to the spread. Instead, he began targeted therapies based on an EGFR mutation. He first went on Gilotrif (afatinib), an oral medication that inhibits cell growth signaling in tumors. He then started Tagrisso (osimertinib), which targets tumors in the brain by binding to mutated proteins. He remained on Tagrisso for six years—longer than his expected survival date. He is now on Rybrevant (amivantamab), a targeted antibody therapy that blocks cancer growth signals and helps the immune system attack cancer cells. A recent CT scan showed that the tumors have shrunk significantly, with some nodules resolving and being replaced by scar tissue. Side effects have been manageable, mostly skin issues such as acne and fingernail infections. He continues to bike to his appointments. His treatments have been covered by national health insurance.

Another patient, a 32-year-old mother and medical school graduate, was diagnosed with stage 4 desmoplastic small round cell tumor (DSRCT)—an exceptionally rare soft tissue sarcoma usually found in children, with fewer than 1,000 documented cases. Symptoms included abdominal pain, weight loss, and nausea. A CT scan revealed a large tumor compressing the colon. She began a chemotherapy regimen at UT MD Anderson. After completing six rounds, she was deemed a good candidate for surgery. A surgical oncologist removed all the remaining cancer in a four-hour procedure. She has shown no evidence of disease since the surgery, though her chances of recurrence remain high.

A third patient was diagnosed with stage 4 gastro-oesophageal cancer. She has undergone immunotherapy, radiation, and chemotherapy. Her latest scans show a strong positive response—the primary tumor has significantly reduced, and there is currently no new spread detected. However, in New Zealand, her immunotherapy drug Nivolumab is unfunded. The projected cost of treatment exceeds $100,000 over the full course. She is currently on income protection, receiving only 75% of her salary, making covering these costs extremely challenging.

The most common form of lung cancer, non-small cell lung cancer (NSCLC), accounts for 85% of all cases. Symptoms can be mild, leading to diagnosis at stage 3 or 4 when treatment is more difficult. While smoking remains the biggest risk factor, other risks include radon, asbestos, air pollution, and radiation therapy. There are currently no annual lung cancer screening recommendations for non-smokers in the U.S.