What happened, in summary

A 55-year-old man was diagnosed in January 2023 with poorly differentiated squamous cell carcinoma in the right lung and a painful tumor in the left femur, consistent with metastatic disease. He received two cycles of paclitaxel and cisplatin, which reduced the lung lesion and eased his cough. Radiation was then given to the femur, and he received three administrations of immune-checkpoint therapy. Tumor testing showed PD-L1 expression in almost all cancer cells.

By June 2023 he developed repeated difficulty with bowel movements. Colonoscopy and surgery identified squamous carcinoma in the transverse colon consistent with spread from the lung, and extensive abdominal metastases were seen during the operation. A transverse colostomy relieved his abdominal pain initially.

His condition then deteriorated with recurrent abdominal pain, nausea, vomiting, gastrointestinal bleeding, jaundice and cachexia. Imaging showed extensive progression. Palliative care was planned, but he chose to leave the hospital and received no further treatment.