"CT scan of the abdomen shows the patient to have multiple bilateral, too numerous to count, liver lesions consistent with widespread liver metastases."

My jaw dropped as I read the report.  My vision blurred.  The world before my eyes spun and came to a standstill. Reeling, I fumbled for a bench outside near a sign which proclaimed, "There is Always Hope."

I had woken up feeling laid-back,  looking forward to the father-daughter school dance that evening.

I had a CT-scan the day before, the final requirement to enter my planned immunotherapy clinical trial, but didn't worry about it. My disease — metastatic colon cancer — has been slow growing and predictable for five years.

No more.

I learned that my liver had exploded with new tumors. Too many to count.  Some quite large. I knew what this meant.  A much more aggressive disease in an essential organ – the type of situation that screamed, life-threatening.  Near-term life threatening.

My oncologist and I reviewed the images together.  My liver looked like Swiss cheese covered in large spots, including a few that were dangerously circling around my biliary duct.  If they grew just a bit more and blocked that duct, an emergency stent operation would be needed.  If that didn't work ... Game over.

All at once, I had gone from excited newcomer to a clinical trial of an exciting immunotherapy, to a possible game-over.

Welcome to the crazy rollercoaster world of Stage IV cancer.  A world where you are constantly being scanned, each new scan a game of Russian roulette.  This is why "scanxiety" is very real.  My entire life changed with this single scan.

Even before my oncologist spoke, I had already come to the same conclusion: Immunotherapies are slow, chemotherapy is fast.  Stop the clinical trial.  Get on chemotherapy that very day.

I had no time to lose.

I was disappointed by the clinical trial being abruptly postponed until my liver is under control. Yet even more, I felt determined ready to fight for my life by any means necessary.

As a Stage IV patient you learn to react to new data on a dime.  I was in that chemotherapy infusion room to save my life, get my liver ready for a future clinical trial and fight on.

Further battle hardened and ready to take that homerun swing.

Yes, I did make it to that father-daughter dance.  We had a great time.

There is always hope.

Dr. Tom Marsilje is a 20-year oncology drug discovery scientist with "currently incurable" stage IV colon cancer. He also writes a personal blog on life at the intersection of being both a cancer patient and researcher "Adventures in Living Terminally Optimistic," a science column for Fight Colorectal Cancer "The Currently Incurable Scientist", and posts science and advocacy updates to Twitter@CurrentIncurSci. This guest column appears on Diagnosis: Cancer through our partnership with Inspire, an Arlington, Va., company with condition-specific online support communities for over a million patients and caregivers.

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