Direktorka

“Stage 4 cancer" gets heard as a death sentence, but it isn’t one. It’s a description of location. Staging answers a single question: where is the cancer? Stage 4 means it has spread beyond the organ it started in, and nothing more than that. It doesn’t tell you how aggressive the tumor is, what drives it or how long someone has. We hear it as a verdict because for a long time it mostly was, and that has changed unevenly. Metastatic testicular cancer is cured in around 90% of men, and advanced Hodgkin lymphoma is similar, both were near-uniformly fatal a few decades ago. Colorectal cancer that has spread to the liver or lungs can sometimes be removed surgically, with people disease-free a decade later. Metastatic melanoma used to kill within months and now has patients off treatment years on with clean scans. Ofc, for several cancers, stage 4 remains incurable: Pancreatic cancer in that stage won't be cured for most patients despite recent progress. But incurable and untreatable are different words, and confusing them costs people time they could have had. When you look up survival statistics, you are reading history: a 5 year figure published today describes people diagnosed seven to ten years ago and treated with what existed then. Where treatment has moved fast, that number is systematically pessimistic about the person sitting in front of me, because the patients living the current numbers haven’t been counted yet. So the questions that matter aren’t about the number. What’s the molecular profile of the tumor, is there a targetable driver, is there a trial, can anything be removed or radiated? Stage 4 is where the cancer is. It isn’t how long you have.