How a Stage 4 Cancer Patient Found Hope
- A New York City man’s cancer journey began with alarming fatigue from simply walking up his home’s staircase that led to a metastatic (stage 4) colon cancer diagnosis, shaking his family but strengthening their resolve to face the disease together.
- “Stage 4 colon cancer can be one tiny spot on the liver, or it could be 100 spots throughout the abdomen, and obviously those patients are going to be treated differently,” Dr. Daniel Labow at Mount Sinai Health System explains of metastatic colon cancer’s ability to spread beyond the colon.
- After chemotherapy successfully shrank his tumors enough for surgery, he found added hope with opening the door to hepatic artery infusion (HAI) therapy—a targeted liver-directed treatment that offered new hope for remission.
- HAI involves placing a “small device placed under the skin of the abdomen and connected to the hepatic artery,” Dr. Nicholas Hornstein, GI Medical Oncologist at Northwell’s Lenox Hill Hospital, explained to SurvivorNet.
- “HAI is regional therapy, meaning it targets the liver specifically, increasing drug exposure and reducing side effects traditional chemo brings due to it being spread throughout the body,” Dr. Hornstein explains.
“I was extremely fatigued and had a difficult time walking upstairs. That was a big wake‑up call,” he told SurvivorNet. One morning, he turned to his wife, Natasha, and asked, “Should I go to the doctor?” Her response was immediate: “Absolutely.”
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Bloodwork soon delivered the news that would change their lives—Philip had metastatic colon cancer.
Stage 4 colon cancer means the disease has spread beyond the colon to other organs. The liver, lungs, and peritoneum—the lining of the abdomen—are the most common sites of metastasis. Because the extent of spread varies widely, treatment plans must be tailored to each individual.
“A stage 4 can be one tiny spot on the liver, or it could be 100 spots throughout the abdomen, and obviously those patients are going to be treated differently,” explains Dr. Daniel Labow, Chief of the Surgical Oncology Division at Mount Sinai Health System.
“Effective chemotherapy and effective surgery are both important for the best possible outcome, and part of the job is figuring out which one should come first.”
WATCH: Not All Metastatic Colon Cancer Patients Are the Same
A Diagnosis That Shook Their World
The moment he heard the words, Philip’s mind went straight to his family.
“I was terrified. The first thing I thought about was my family. Am I ever going to see them again? How long do I have?” he said.
Natasha was by his side when the doctor explained the diagnosis, absorbing the shock with him. Despite losing several relatives to cancer, she felt an unexpected sense of calm.
“Even though it was the worst possible diagnosis, I immediately had this gut feeling that it was going to be okay,” she said.
Their 23‑year‑old son responded with the same quiet strength.
“He’s this stoic kid who just knew he had to be strong for his dad,” Natasha said. “He told him, ‘Don’t worry, Dad. We’ll get through this.’”
For Philip, that support became the foundation of his fight. “Without my family, I couldn’t have done this cancer journey,” he said.
Treatment Decisions to Battle Stage 4 Cancer
Since Philip’s cancer had already spread, his care team initially described his treatment as palliative—focused on managing symptoms until a clearer path emerged. The plan was to begin chemotherapy and reassess whether surgery might eventually be possible.
“So the care team explained I would go through a series of chemo treatments, and we’d see what would happen,” Philip said.
To everyone’s relief, the chemotherapy worked. The tumors shrank enough for surgeons to remove the cancer in his colon through surgery. That moment marked a turning point—one that opened the door to a treatment that would ultimately offer Philip and his family even more renewed hope.
The Hope of HAI Therapy
After surgery, Philip’s doctors recommended adding a hepatic artery infusion (HAI) pump to his treatment plan. The device delivers high‑dose chemotherapy directly into the liver, where metastatic colon cancer often spreads.
“The best candidates are patients with colorectal cancer or hepatobiliary cancer that has spread predominantly or exclusively to the liver, where controlling liver disease is the main clinical challenge. They need adequate liver function and anatomy that allows safe pump placement and infusion, and they also need to be able to engage in close follow-up. Many programs focus on patients with unresectable liver-limited disease, but HAI can also be used around liver surgery in selected high-risk cases,” Dr. Hornstein explained.
For patients like Philip, it can be a powerful tool—one that targets liver tumors more aggressively while limiting whole‑body side effects.
“With traditional systemic chemotherapy, the drug circulates throughout the entire body, which is necessary when the disease is widespread, but also drives many side effects. HAI is regional therapy: it targets the liver specifically, so the liver tumors see much higher drug exposure than you can safely achieve through an IV regimen. In practice, HAI is often used alongside systemic therapy rather than replacing it,” Dr. Hornstein explained.
Philip didn’t hesitate. “I said, ‘I’ll follow whatever instructions you tell me to do,’” he recalled.
The most common side effects are liver-related, such as elevated liver enzymes or biliary irritation. But compared with standard IV chemotherapy, patients often experience fewer whole-body effects because far less of the drug circulates systemically.
Dr. Hornstein believes the future of HAI lies in more intelligently combining it with newer systemic therapies and exploring alternative drugs and delivery strategies to better target tumor biology.
“I think the role of HAI will increasingly center on how intelligently we combine it with newer systemic therapies and biologic agents. There is also growing interest in whether we should rethink what goes into the pump itself, including alternative drugs, schedules, and delivery strategies to better exploit tumor biology. Over time, the field will likely move toward more personalized regional therapy,” Dr. Hornstein said.
Coping With Treatment and Its Side Effects
The early days of treatment were difficult. Fatigue hit hard, and losing his hair took an emotional toll.
“When I started losing my hair, I got sad and depressed,” he said. “But once it was gone, it became liberating. I thought, I have nothing to worry about now—let me just go through the treatments.”
Through it all, Natasha and their son tag‑teamed caregiving duties. “It was heartbreaking,” Natasha said. “You just try to keep their spirits up and their fears down.”
Caregivers often emerge from a patient’s close support circle: a spouse, parent, sibling, friend, or even a child. These individuals take on multiple roles to ease the journey for someone they care deeply about.
Finding Strength in Small Steps
After surgery and the HAI pump placement, Philip was surprised by how well he recovered. He didn’t lose control of his bodily functions, and he didn’t experience major side effects from the pump.
During the height of treatment, Philip took time off work to focus on healing. But slowly, he began reclaiming pieces of his life.
“I was able to get up, do things, walk the dog, and continue doing certain things I had normally completed in the past,” he said. Those small moments of normalcy helped him feel like himself again.
A New Chapter: Cancer‑Free
By fall 2025, after months of chemotherapy, surgery, and HAI therapy, Philip’s scans showed no evidence of disease. He was declared cancer‑free.
“It took a couple of months for me to realize, hey, this might be the end of it,” he said. “It’s a great feeling once you ring the bell.”
For Natasha, that moment was filled with tears—of relief, gratitude, and release. “Ringing the bell… it was just lovely,” she said.
A Journey Defined by Hope
Philip’s experience reflects how far cancer treatment has come. Where once his family history suggested little hope, today’s therapies—including HAI—offered him a path not just to more time, but to remission.
Most of all, it offered his family the chance to imagine a future together.
As Philip looks back on the journey, one truth stands above all: “Without my family, I couldn’t have done this,” he said. “But with them, I got through it.”
Expert Resources for Colorectal Cancer Patients
- Management of Metastatic Colon Cancer
- Identifying KRAS Mutations To Personalize Colon Cancer Treatment
- Why a Tailored Approach to Colon Cancer Treatment Matters
- How to Approach Treatment for Advanced Colon Cancer
- New Drug Combination For Advanced Colon Cancer Highlights The Importance Of Biomarker Testing: What Patients Need To Know
Coping With an Advanced Colon Cancer Diagnosis
“The first-line (initial treatment) chemotherapy for metastatic colon cancer, if they’ve not seen any other chemotherapy before, is the standard FOLFOX,” Colorectal Surgeon and Surgical Oncologist Dr. Heather Yeo told SurvivorNet.
“Most colon cancers do respond to FOLFOX. If you respond really well, then we keep you on that until you stop responding really well. But if after a few cycles your disease has progressed, that’s when we think about adding additional chemotherapies,” Dr. Yeo continued.
WATCH: Managing Metastatic Colon Cancer
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. If you don’t have these polyps removed, they can sometimes change into cancer. It takes up to 10 years for a colon polyp to become a full-blown cancer, according to SurvivorNet experts.
“When we see a polyp, we actually physically take the polyp out through the colonoscope,” Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, explained.
WATCH: When to get a colonoscopy
Most colon cancers can be prevented if people are regularly screened. The screening usually involves a colonoscopy, in which a long, thin tube attached to a camera examines the colon and rectum. If no polyps are discovered, the following screening won’t be needed for about ten years.
What Treatment Options Exist for Colon Cancer?
“There are a lot of advances being made in colorectal cancer,” Dr. Yeo previously told SurvivorNet.
Colon cancer treatment is more targeted, meaning doctors often test for specific changes or genetic mutations that cause cancer growth.
Biomarkers are key to tailoring specific treatments. Biomarkers are molecular patterns becoming more commonly used in colon cancer diagnosis, prognosis, and management. According to the National Cancer Institute, a biomarker is “a biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or a condition or disease,” such as cancer.
WATCH: Molecular Profiling & Colon Cancer — Critical Testing Patients Should Know
“In colon cancer, we’re starting to look more and more at people’s biomarkers, so we’re starting to take the cancers, sequence them, understand where the different mutations are to figure out whether or not someone has a normal gene here or an abnormal gene,” Dr. Yeo explained.
“Those are the areas that people want to be able to target a little bit more. We’re getting close to more of what we would call precision medicine, meaning we can start looking at people’s genetic mutations and think about how they might respond to different drugs.”
There are different types of biomarkers, including DNA, proteins, and genetic mutations found in blood, tumor tissue, or other body fluids. The biomarkers most commonly used in colon cancer management are:
- Genetic mutations within the tumor, such as MMR/MSI, KRAS, BRAF, and HER2
- Bloodstream carcinoembryonic antigen (CEA)
CEA is a protein produced by most tumor cells (but not all) and can be picked up in the bloodstream. High CEA levels do not establish a colon cancer diagnosis. However, higher CEA levels correlate with a worse prognosis and potential metastasis. Carcinoembryonic antigen is important for post-treatment follow-up to ensure the cancer hasn’t returned. Be sure to check with your doctor before treatment starts to ensure a CEA blood sample has been obtained.
More on Treating Colon Cancer
Surgery and chemotherapy are common approaches to colorectal cancer.
Some examples of Food and Drug Administration (FDA) approved chemotherapy drug treatments include:
- FOLFOX: leucovorin, 5-FU, and oxaliplatin (Eloxatin)
- FOLFIRI: leucovorin, 5-FU, and irinotecan (Camptosar)
- CAPEOX or CAPOX: capecitabine (Xeloda) and oxaliplatin
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan
- Trifluridine and tipiracil (Lonsurf)
WATCH: Understanding Your Options with Metastatic Colon Cancer
Among metastatic colon cancer patients, multiple treatment options exist, including surgical and non-surgical options.
One treatment option includes an oral treatment called Fruquintinib, which is a targeted therapy for adults who have metastatic colorectal cancer and have tried other treatments. Results from a trial published last year showed the drug improved overall survival and progression-free survival, which measures the amount of time before the cancer returns or spreads. It works by blocking the growth of blood vessels, which increases tumor growth.
Once you get to the metastatic setting, many patients “just run out of options,” Jennifer Elliott, head of solid tumors at Takeda, explained to SurvivorNet at the ASCO Annual Meeting. So it was critically important for Takeda to do this deal to in-license fruquintinib. We hope to give patients another option.”
Fruquintinib has been approved in China since 2018 and was originally developed by the Chinese biopharmaceutical company HUTCHMED. Takeda Oncology acquired the exclusive worldwide license for the drug outside of mainland China, Hong Kong, and Macau in January 2023.
More on Colon Cancer
Colon cancer is very treatable and curable if caught early. Colon cancer screenings can involve at-home tests such as Cologuard, but a colonoscopy is more effective, according to SurvivorNet experts.
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. It takes up to 10 years for a colon polyp to become full-blown cancer, according to SurvivorNet experts.
The American Gastrointestinal Association lowered the recommended initial age for colorectal screening from 50 to 45. However, experts recommend screening earlier for some people who may be at an increased risk of developing colon cancer, such as those with a family history of the disease.
WATCH: Debunking misconceptions about colon cancer.
The most poignant signature of colon cancer includes a change in bowel habits. This may include constipation or diarrhea due to changes in the size or shape of bowel movements. A change in stool color, particularly black or tarry stools, can indicate bleeding from a tumor that lies deep in the colon.
Other symptoms can be harder to pinpoint, such as abdominal pain and unintentional weight loss. Finally, some tumors bleed a small amount over a long period of time, resulting in anemia (low red blood cell count) that is picked up on blood work.
Questions to Ask Your Doctor
If you are facing a colon cancer diagnosis, here are some questions you may ask your doctor.
- What are my treatment options based on my diagnosis?
- If I’m worried about managing the costs of cancer care, who can help me?
- What support services are available to me? To my family?
- Could this treatment affect my sex life? If so, how and for how long?
- What are the risks and possible side effects of treatment?
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