CASE SELECTION 2: Long-Term Survival with Extensively Metastatic Colorectal Cancer

“Case Selection” is a new format designed to highlight inspiring patient cases focused on challenging situations such as multiple recurrences, extensive metastases, rare subtypes, no longer response to standard treatments. Each case is derived exclusively from peer-reviewed medical journal case reports, rewritten by Patient Savvy in clear, easy-to-understand language without altering any critical information.

This collection highlights real stories of stage 4 colorectal cancer patients with extensive metastases to uncommon sites who achieved long-term survival through multiple lines of treatment—options often not fully detailed in standard guidelines (You can download FREE HERE). Their experiences show the power of self-advocacy and the importance of speaking with your doctor about personalized treatment paths.

Sonya’s 5-year cancer-free

Stage IV colorectal cancer, metastasized to liver, ovary, and lymph nodes
Six rounds of chemo, abdominal surgery, followed by six more rounds of chemo

When 41-year-old mother of two, Sonya Z., was told she had Stage IV colorectal cancer just weeks shy of her 42nd birthday, she was stunned. Up until then, Sonya had been focusing on rebuilding her life post-divorce, thriving in her tech manager role at a charter school, and celebrating recent academic achievements. A routine checkup revealed enough red flags for her doctor to recommend a colonoscopy—something Sonya initially postponed. However, the procedure quickly led to the devastating words: “I think that’s cancer.”

Further testing confirmed metastatic colon cancer with tumors in her liver, ovary, and lymph nodes. Sonya’s treatment plan resembled a nine-month “pregnancy” in three trimesters: six rounds of chemotherapy, abdominal surgery, and another six rounds of chemo. Throughout it all, she endured challenging side effects such as intense neuropathy, scalp sensitivity, peeling skin, and hair loss—yet she found a beacon of hope in humor.

Sonya nicknamed her port-a-cath “Portia Fortenport,” embraced her “spa days” at the oncology ward, and turned awkward moments into comedic relief whenever possible.

Surgery successfully removed Sonya’s sigmoid colon, affected liver segments, ovary, and lymph nodes. Sixteen months after she started, she bid a celebratory farewell to “Portia.” Now cancer-free for five years, Sonya reflects on what helped her most: laughter, love, and community support. She encourages newly diagnosed patients to let others help so they can focus on healing, highlighting that early detection, research, and fundraising are steadily improving colorectal cancer survival rates.

Above all, Sonya found her will to fight by thinking of her children. “I never wanted my kids to see that cancer could win,” she says, reminding others that it’s crucial to have a plan but equally important to find reasons to live and laugh each day.

Source:  Colon Cancer Coalition

Ida’s journey from “terminal” to cancer-free

Stage IV colorectal cancer with spread to liver, lungs, and pelvis
Multiple lines of chemotherapy, radical pelvic surgery, and an innovative three-drug immunotherapy trial

At age 51, Ida Y. noticed blood in her stool but assumed it stemmed from hemorrhoids. A routine colonoscopy revealed a malignant rectal tumor, and scans showed the cancer had already spread to her liver, lungs, and pelvic area. An initial oncologist told her she had only six months to live. Determined to fight, Ida sought a second opinion at City of Hope, where she met Dr. Marwan Fakih. Hearing him say, “No one can tell you how long you can live,” restored her hope.

First, Ida underwent intensive chemotherapy for 18 months to shrink tumors in her rectum and liver. Encouraging scan results paved the way for surgery in June 2018, where surgeons removed her rectal tumor and excised or ablated liver lesions. She also had a liver pump inserted to deliver targeted chemotherapy. Unfortunately, her cancer recurred by early 2019, spreading to her pelvis and lungs. Multiple treatments over the next 18 months proved temporary; the disease continued to progress, causing severe bleeding.

In June 2020, Ida met Dr. Andreas Kaiser. To stop life-threatening hemorrhaging, he performed a major operation removing her rectum, anus, bladder, uterus, and vagina. She woke with two permanent ostomy bags—an overwhelming adjustment. Worse yet, new scans soon revealed further cancer growth, and Ida exhausted all standard chemotherapy options.

Facing critical circumstances, Dr. Fakih offered a final possibility: a Phase I clinical trial combining immunotherapy with targeted therapy. Ida began treatment in August 2020, experiencing minimal side effects. Within four months, her tumors began “melting away,” and subsequent scans confirmed no evidence of disease. Ida completed the trial in late 2022, and she remains free of active cancer, monitored by CT scans every three months.

Today, Ida travels the world—including two dream trips to Paris—cherishing every moment with her family. She credits the care and pioneering research at City of Hope for giving her a future she was once told she wouldn’t have.

Source: City of Hope (Published in April 2023)

Xun’s 7-year story

Stage IV rectal adenocarcinoma with metastases to ovary and lymph nodes, KRAS G12D mutation
7 surgeries (incl. pelvic exenteration), multiple chemotherapy regimens, radiotherapy, and targeted interventions

In October 2015, Xun, a 51-year-old woman sought medical attention at Zhujiang Hospital for bowel habit changes lasting over six months. Investigations revealed a 3×3 cm rectal mass located 7 cm from the anus. Colonoscopy confirmed a cauliflower-like tumor at the rectosigmoid junction, with elevated CEA (85.2 μg/L) and CA199 (82.1 kU/L). Postoperative pathology identified a moderately differentiated adenocarcinoma that had infiltrated the entire intestinal wall, invaded vasculature and nerves, and spread to the right ovary and mesenteric lymph nodes. Genetic testing detected a KRAS G12D mutation, and the final staging was pT4bN2aM1b(stage IV).

Initially, laparoscopic radical surgery and right ovariectomy were performed, followed by six cycles of XELOX (oxaliplatin and capecitabine). However, 22 months later, imaging revealed metastases near the left iliac vessels. A second laparoscopic exploration removed the left ovary and the metastatic mass, and six cycles of FOLFIRI (irinotecan, 5-FU, calcium folinic acid) ensued.

In 2019, additional recurrences required local radiotherapy, second-line chemotherapy (FOLFIRI plus bevacizumab), and ultimately a third laparoscopic surgery in March 2021, which included partial rectal resection and sigmoid colostomy.

When imaging in mid-2021 showed progression at the rectal stump, radiofrequency ablation and particle implantation were conducted, and regorafenib was started as third-line therapy. By July 2022, persistent tumor growth led to the decision for pelvic exenteration, a major procedure removing the rectum, anus, bladder, vagina, and part of the sacrum. Because of the extensive surgical wound, a free myocutaneous flap graft and debridement were performed in September 2022.

Remarkably, more than seven years after her initial diagnosis, this patient’s tumor markers remain within normal limits. She lives independently with a fistula bag but experiences little restriction in her daily activities. Follow-up assessment using the FACT-C questionnaire indicates a satisfactory quality of life and a hopeful outlook.

Source: Ouyang, et al. (2023). Frontiers in Oncology, 13, 1169616.

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