Cancer Survivor Story: How I Got Diagnosed with Lung Cancer

Patient Info: Ashley, Female, Under 40 | Stage IV

Biomarkers: EGFR-positive; T790M mutation

Metastatic Site: Both lungs

As of August 2021, Ashley had been living for almost 4 years with incurable but treatable EGFR-positive T790M non-small cell lung cancer involving many tiny nodules across both lungs.

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Stage IV gastric cancer treated with chemotherapy and hyperthermia in a patient with a vagus nerve stimulator

Patient Info: Anonymized, male, 50s | Stage IV

Metastatic Site: para-aortic lymph nodes, peritoneum

The gastric tumors and lymph-node disease initially shrank during treatment, but peritoneal dissemination developed. He died from progressive gastric cancer 8 months after treatment began.

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Triple-negative breast cancer first discovered through a duodenal metastasis

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: ER-negative; PR-negative; HER2-negative; CK7-positive; GATA3-positive; vimentin-positive; CDX2-negative; CK20-negative., triple negative

Metastatic Site: duodenum

She died two days after choosing comfort-focused care, following rapid decline from metastatic triple-negative breast cancer with duodenal involvement and small-bowel obstruction.

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Stage IV Invasive Lobular Carcinoma: Carol's Survivor Story

Patient Info: Carol, Female, 60s | Stage IV

Metastatic Site: Bone

Carol had de novo Stage IV breast cancer with bone metastases, achieved complete remission after chemotherapy, stayed on daily Letrozole for 10 years, then returned to NED/no active disease after Kisqali and Faslodex for bone progression.

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Stage IV gastric cancer with low platelets managed so chemotherapy could continue

Patient Info: Anonymized, female, 60s | Stage IV

Chemotherapy was able to continue after partial splenic embolization, but the gastric cancer later progressed and she died from the disease.

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Stage IV gastric cancer with low platelets managed so chemotherapy could continue — Case 2

Patient Info: Anonymized, female, 70+ | Stage IV

After partial splenic embolization, her platelet count recovered and thrombocytopenia did not recur. She was receiving second-line ramucirumab plus paclitaxel at the latest follow-up.

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Stage 4 Ovarian Cancer Discovered During Trigeminal Neuralgia Evaluation

Patient Info: Anonymized, Female, 50s | Stage IV

Three months after surgery, she had recovered well from debulking and 6 total chemotherapy cycles, with complete macroscopic clearance achieved at surgery. Trigeminal-neuralgia symptoms persisted and continued to require daily medication.

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Facial paralysis from progression of EGFR-positive metastatic lung cancer improved with osimertinib

Patient Info: Anonymized, Female, Under 40 | Stage IV

Biomarkers: EGFR exon 21 p.Leu858Arg mutation.

Metastatic Site: brain; leptomeninges and facial nerves

Osimertinib rapidly resolved the bilateral facial weakness and reduced the brain lesions, but after 15 months seizures recurred and three smaller brain metastases had increased in size.

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Alectinib restored vision from an eye metastasis of ALK-positive lung cancer

Patient Info: Anonymized, Male, 60s | Stage IV

Biomarkers: ALK-positive.

Metastatic Site: right choroid of the eye; liver; bone; brain

After nearly eight months of response to alectinib, the lung cancer progressed in the liver, bone, and brain; lorlatinib was started, but he died on July 3, 2020.

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Stage IV gastric cancer with gastric outlet obstruction treated with a stent

Patient Info: Anonymized, female, 70+ | Stage IV

Metastatic Site: para-aortic lymph nodes

The second stent allowed her to continue eating solid food. She died from progressive gastric cancer 3 months after the repeat stent procedure.

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Young man with hereditary diffuse gastric cancer and a CDH1 mutation

Patient Info: Anonymized, male, Under 40 | Stage IV

Biomarkers: CDH1 c.639G>A nonsense mutation, decreased E-cadherin expression

His health deteriorated rapidly and he died 4 months after the Stage IV diagnosis without receiving anticancer treatment.

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Pleomorphic Lung Cancer Progressed Despite Pembrolizumab

Patient Info: Anonymized, Male, 70+ | Stage IV

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; PD-L1 TPS 80%-90%.

Metastatic Site: small intestine; pleura; abdominal subcutaneous tissue

The cancer did not respond to pembrolizumab, and he died four months after immunotherapy began.

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Pembrolizumab Controlled Metastatic Pleomorphic Lung Cancer After Chemotherapy Failed

Patient Info: Anonymized, Male, 40s | Stage IV

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; BRAF-negative; PD-L1 TPS 60%-70%; BRCA2, and TP53 mutations; tumor mutation burden 42 mutations/Mb; no actionable alteration.

Metastatic Site: right adrenal gland; left adrenal gland; bone

Tumor diameter had decreased at 11 months, and pembrolizumab remained ongoing at 12 months.

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Hyperosmolar hyperglycemic crisis during capecitabine treatment for metastatic breast cancer

Patient Info: Anonymized, Female, 70+ | Stage IV

CT during hospitalization showed reduction in her known metastatic lesions while capecitabine was held because of a severe hyperglycemic crisis.

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A painful scalp metastasis from sarcomatoid lung cancer

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: No targetable mutations identified; CAM5.2-positive; p63-positive; CD10-positive; vimentin-positive.

Metastatic Site: chest wall and rib; liver; right gluteal region; scalp…

Her disease progressed with a further liver lesion and additional metastatic complications, and systemic treatment was stopped because of severe immune-related toxicity and the absence of targetable mutations.

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Rapidly progressive AFP-producing gastric cancer with widespread metastases and severe blood-clotting complications

Patient Info: Anonymized, male, 50s | Stage IV

Biomarkers: AFP-positive

Metastatic Site: liver, lymph nodes, bone, muscle, subcutaneous tissue

He died shortly after presentation from a massive brain hemorrhage in the setting of disseminated intravascular coagulation, before systemic anticancer treatment could be started.

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Breast cancer recurrence in the mandibular condyle causing jaw pain

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: ER-positive; PR-positive; HER2-negative.

Metastatic Site: right mandibular condyle with extension into the…

After anastrozole and 60 Gy of radiation, her jaw pain, mouth opening, and function improved, although some discomfort remained and palliative systemic treatment was continuing.

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Severe immune thrombocytopenia during treatment for metastatic colon cancer

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: KRAS-mutated; microsatellite stable; BRAF-wild type.

Metastatic Site: bilateral ovaries; pelvis; peritoneum; mesenteric…

After multiple metastatic recurrences and treatment changes, she died from progressive colon cancer; oxaliplatin had been permanently stopped after antibody-confirmed immune thrombocytopenia.

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Bilateral adrenal bleeding during bevacizumab treatment for metastatic colon cancer

Patient Info: Anonymized, Male, 50s | Stage IV

Biomarkers: RAS-mutant; BRAF-wild type; microsatellite stable.

Metastatic Site: peritoneum; liver; lung

Despite multiple systemic and local treatments, his metastatic colon cancer progressed in the liver and peritoneum, and he died from disease progression in November 2018.

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Lung adenocarcinoma first detected through an adrenal metastasis

Patient Info: Anonymized, Male, 60s | Stage IV

Biomarkers: No driver mutations identified.

Metastatic Site: left adrenal gland

After resection of the adrenal metastasis, postoperative imaging showed further thoracic uptake and he began palliative chemotherapy for metastatic lung adenocarcinoma without identified driver mutations.

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Likely lung carcinoma presenting as bilateral adrenal metastases

Patient Info: Anonymized, Male, 70+ | Stage IV

Metastatic Site: bilateral adrenal glands

Three months after bilateral adrenalectomy, he remained under regular oncology surveillance, was receiving steroid replacement, and had not required adjuvant chemotherapy.

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Ramucirumab and paclitaxel for metastatic gastric cancer in a patient receiving hemodialysis

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-negative

Metastatic Site: liver, distant lymph nodes

After about 16 months of disease control on paclitaxel plus ramucirumab, multiple liver metastases and distant lymph nodes progressed. Third-line irinotecan was stopped after severe toxicity, and supportive care followed.

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Right breast cancer with contralateral axillary lymph-node metastasis

Patient Info: Anonymized, Female, 60s | Stage IV

Biomarkers: Right breast primary: ER-positive; PR-positive; HER2-negative; Ki-67 70%. Left axillary metastasis: ER-positive; PR-negative; HER2-negative; Ki-67 15%; GATA3-positive.

Metastatic Site: contralateral left axillary lymph nodes

Two years after bilateral surgery, clinical and radiological follow-up showed no metastasis or disease recurrence.

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Stage IV Colorectal Cancer: Lee's Survivor Story

Patient Info: Lee Jones, Male, 50s | Stage IV

Metastatic Site: Liver

As of February 2021, Lee reported no evidence of colon cancer since 2011 after treatment for Stage IV colon cancer with liver metastases, recurrence, chemotherapy, colon surgery, and liver surgery.

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