Strength for the Journey Virtual Retreat October 5, 2026
Strength for the Journey Virtual Retreats with Dr Sharon May
October 5, 2026 from 3-3:45pm EST– Letting Love Meet Me Here
Strength for the Journey Theme: Love Wholeheartedly
Cancer affects relationships. Some people show up beautifully. Some disappear. Some say the wrong thing. Some try to help but do not know how. Many people find themselves trying to protect everyone else emotionally while also carrying their own fear, pain, and exhaustion.
This retreat explores what it means to love and be loved in the middle of vulnerability. Participants will reflect on receiving help, asking for what they need, setting boundaries, having honest conversations, and allowing love to become simpler, more practical, and more present.
Coaching Questions:
“What kind of support actually helps me?”
“What am I tired of pretending is okay?”
“What conversation might bring more honesty, closeness, or relief?”
________________________________________
Location: Online, Zoom link provided upon registration.
Cost: Free of charge
Limited Spots Available- Reserve Your Spot Today!
Strength for the Journey Virtual Retreat November 2, 2026
Strength for the Journey Virtual Retreats with Dr Sharon May
November 2, 2026 from 3-3:45pm EST– Wisdom for the Hard Days
Strength for the Journey Theme: Live Wisely & Resiliently
Some days require courage. Other days require wisdom. This retreat focuses on emotional steadiness, self-compassion, energy management, scanxiety, uncertainty, and practical resilience for the hard days of cancer.
Rather than defining resilience as “staying strong,” this retreat reframes resilience as learning how to return to yourself again and again. Participants will explore the difference between what is theirs to carry and what is not, how to respond to fear without being ruled by it, and how to make wise choices when energy is limited.
Coaching Questions:
“What does my body need from me today?”
“What helps me come back to myself when fear rises?”
“What is one kind thing I can do for myself this week?”
________________________________________
Location: Online, Zoom link provided upon registration.
Cost: Free of charge
Limited Spots Available- Reserve Your Spot Today!
In-Person Retreat: When Life Changes Everything, A Day of Hope, Strength, & Connection November 7, 2026
A Day of Hope, Strength & Connection with Dr. Sharon May, Dr. Sylvia Hart Frejd, & Dr. Kevin Ellers.
On November 7th, 2026 from 10am-3pm EST- A restorative day of hope, strength & connection
If you are navigating cancer, serious illness, caregiving, or another life-changing season, this hope and resilience retreat offers a meaningful day to pause and reconnect.
As Stage4Hope brings its retreat experience to Highlands, participants can connect with others and find renewed strength. Take time to reflect, receive encouragement, and feel supported on your journey.
The retreat will be facilitated by Dr. Sharon May, Dr. Sylvia Hart Frejd, and Dr. Kevin Ellers. All three are experts in trauma, resilience, relationships, and mind-body wellness.
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Location: 471 Main Street Highlands, NC
Cost: Free of charge
Limited Spots Available- Reserve Your Spot Today!
How Cancer Spreads and Survives
Why Understanding Cancer Spread Matters
For patients facing Stage 4 cancer, one of the most difficult parts of the diagnosis is understanding how cancer spreads—and what can be done to stop it.
Cancer spread, also called metastasis, happens when cancer moves from its original location to other parts of the body. In fact, the vast majority of cancer deaths are caused not by the original tumor, but by the effects of metastatic cancer.
While that can feel overwhelming, researchers are learning much more about how metastatic cancer cells survive, hide, and eventually grow in other parts of the body. These discoveries could point toward new Stage 4 cancer treatments and more personalized approaches to care.
New Discoveries About How Cancer Spreads
Researchers at Memorial Sloan Kettering Cancer Center (MSK), led by metastasis researcher Joan Massagué, PhD, are uncovering important insights into how cancer spreads.
One discovery is that metastatic cancer cells can become unusually flexible. They can access cellular programs normally associated with much earlier stages of development, giving them the ability to adapt to different environments and potentially resist treatment.
Researchers have also found that some cancer cells can enter a dormant state. Instead of actively growing, these cells can remain hidden from the immune system until conditions allow them to become active again. This may help explain why cancer can sometimes return long after initial treatment.
MSK scientists identified a signaling pathway called STING that may be important during this process. As dormant cells begin growing again, increased STING activity can make them more visible—and potentially more vulnerable—to the immune system. Researchers are studying whether this window could eventually be used to help immune defenses destroy metastatic cells.
Scientists are also learning that different cancers can use different strategies to spread to the same organ. Understanding those differences could eventually help doctors target the specific vulnerabilities of each cancer more precisely.
Can Genetics Predict Where Cancer Spreads?
Additional MSK research adds another important piece to the metastasis puzzle. Scientists analyzed genomic information from approximately 25,000 patients across 50 cancer types to investigate whether a tumor’s genetic mutations could predict whether—and where—it would spread.
Researchers found associations between certain genetic changes and patterns of metastasis, but genetics alone could not reliably predict exactly where an individual patient’s cancer would spread.
The findings suggest that metastasis is more complex than a single mutation. How genes are regulated, how cancer cells interact with their surrounding environment, and how tumors continue to change as they progress may all influence cancer’s ability to spread.
For patients, this research could eventually contribute to more personalized cancer treatment, monitoring, and assessment of metastatic risk as scientists combine genomic information with increasingly detailed clinical data.
What This Means for Patients
For people living with Stage 4 cancer, understanding metastasis is about much more than understanding why cancer spreads. It is about finding new vulnerabilities that researchers may eventually be able to target.
These discoveries could contribute to:
- New Stage 4 cancer treatment options
- Better strategies for preventing or controlling metastasis
- More personalized treatments based on tumor biology
- Improved use of immunotherapy and clinical trials
- Better ways to identify and target dormant cancer cells
Importantly, researchers emphasize that metastatic cancer is no longer universally viewed as an automatic death sentence. For some cancers, immunotherapy and other advances have made metastasis more treatable, while other advanced cancers are increasingly becoming diseases that can be controlled for longer periods.
How Stage4Hope Helps Turn Research Into Access
New discoveries are creating more options for patients with Stage 4 cancer—but access remains critical.
Stage4Hope helps bridge that gap by:
- Connecting patients to leading cancer centers
- Helping them explore clinical trials and treatment options
- Supporting the logistics of getting there
- Providing virtual retreats and support groups for emotional and spiritual support
👉 Learn more about our work: https://stage4hope.org
If you or someone you love is facing Stage 4 cancer, faster access to care can open new possibilities.
👉 Explore resources: https://stage4hope.org/resources
Healthcare providers can refer patients directly to help accelerate care:
👉 Refer a patient: https://stage4hope.org
References
https://www.mskcc.org/news/how-cancer-spreads-four-emerging-insights
What Cancer Cells Eat to Grow
What Cancer Cells Eat to Grow (Stage 4 Cancer Explained)
Why This Research Matters
For patients facing Stage 4 cancer, new treatments often begin with one important question: What is helping cancer grow—and how can it be stopped?
New research from Memorial Sloan Kettering Cancer Center is focusing on something many people don’t think about—how cancer cells use nutrients to survive.
By understanding how cancer cells “eat,” scientists are uncovering new ways to develop better cancer treatment options and improve outcomes for patients. This type of research may shape the next generation of therapies for people facing advanced cancer.
Understanding How Cancer Cells Grow
At the center of this research is Lydia Finley, whose work focuses on cancer cell metabolism—the way cancer cells convert nutrients into energy and the building blocks they need to grow.
All cells need fuel to function, but cancer cells often depend on certain nutrients more heavily than normal cells. This creates a potential opportunity for treatment.
If researchers can identify what cancer cells rely on, they may be able to:
- Block those nutrients
- Disrupt how cancer cells produce energy
- Slow or stop tumor growth
This research is already leading to important discoveries. In some studies, scientists found that certain molecules, called metabolites, can actually change how cancer cells behave—making them less aggressive and less likely to spread.
In another example, researchers studying a rare childhood cancer identified key nutrients the cancer depended on. They then used an existing drug, methotrexate, to target that process and slow tumor growth.
This type of research may not always lead to immediate treatments, but it plays a critical role in advancing clinical trials and new cancer therapies. Many breakthroughs start with understanding how cancer works at its most basic level.
It also helps explain why some treatments stop working over time. Cancer cells can adapt and find new ways to survive. By understanding metabolism, researchers may be able to stay ahead of that resistance and develop more durable treatment options.
What This Means for Patients
For patients with Stage 4 cancer, research like this represents something important: new possibilities for treatment.
Many of today’s most effective therapies—especially targeted therapy and immunotherapy—started with this kind of foundational research. What may seem like early science today can become tomorrow’s life-saving treatment.
Understanding how cancer cells survive could lead to:
- New Stage 4 cancer treatment options
- More personalized care based on how a patient’s cancer behaves
- Better outcomes with fewer side effects
But discoveries alone are not enough.
Patients must be able to access the right care, at the right time, and at the right place. Many of the most advanced treatments and clinical trials for cancer are available at leading cancer centers—but getting there can be one of the biggest challenges patients face.
Additional Insight: Why Metabolism Research Is Expanding
Research from Dana-Farber Cancer Institute reinforces the importance of this work. Scientists are finding that cancer cells do not all use nutrients in the same way, which means treatments may need to be tailored even more precisely for each patient.
Their research highlights how cancer cells can “reprogram” the way they use energy—allowing them to survive, grow, and even resist treatment. This supports findings from MSK that understanding how cancer cells use fuel is critical to developing more effective therapies.
By identifying these metabolic differences, researchers are working toward treatments that not only target the cancer itself but also cut off the pathways it depends on to survive. This may help explain why some patients respond better to certain therapies—and how new combinations of treatments could improve outcomes.
As this field continues to grow, it is opening the door to more personalized and effective cancer treatment strategies, especially for patients with advanced or treatment-resistant disease.
How Stage4Hope Helps Patients Move Faster
At Stage4Hope, we are focused on one mission:
Helping patients with Stage 4 cancer access life-saving care—faster.
We help patients:
- Connect with leading cancer centers
- Explore clinical trials and treatment options
- Navigate complex care decisions
- Access travel support when distance is a barrier
- Join virtual retreats and support groups for emotional and spiritual support
👉 Learn more about how we support patients: https://stage4hope.org
If you or a loved one has been diagnosed with a late-stage cancer, getting to the right care quickly can make all the difference.
👉 Explore resources and patient support: https://stage4hope.org/resources
Healthcare providers and partners can also refer patients directly to help accelerate access to care:
👉 Refer a patient or partner with us: https://stage4hope.org
References:
https://www.mskcc.org/news/what-cancer-cells-eat-cancer-metabolism-may-hold-key-to-new-treatments
Strength for the Journey Six Virtual Cancer Retreats 2026
Strength for the Journey Six Virtual Cancer Retreats with Dr Sharon May
Strength for the Journey is a six-part virtual retreat series for people facing cancer at any stage. Each gathering follows one of the six Become Your Best themes while speaking directly to the emotional, spiritual, relational, and practical realities of cancer.
These retreats are not about pretending to be fearless. They are about finding strength that is honest, rooted, compassionate, and real. Through guided reflection, research-informed coping tools, meaningful conversation, journaling prompts, and gentle spiritual encouragement, participants are invited to remember: Cancer may be part of your story, but it is not all of who you are. You are still becoming. You are still loved. You are still you.
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July 6, 2026 – Stay Rooted When Life Feels Uprooted
Strength for the Journey Theme: Stay Rooted in Your Faith and What Grounds You
Cancer can make life feel suddenly unstable. Appointments, scans, treatments, side effects, uncertainty, and changing plans can leave women feeling as though the ground beneath them has shifted. This retreat creates a gentle space to return to what still holds: faith, breath, prayer, scripture, values, trusted relationships, memories of strength, and the quiet presence of God.
This retreats helps participants identify what they can return to when they feel afraid, overwhelmed, tired, or alone.
Coaching Questions:
“What grounds me when I do not have answers?”
“What truth can I return to today?”
“What helps me feel held, even when I do not feel strong?”
________________________________________
August 17, 2026 – My Story Is Still Mine
Strength for the Journey Theme: Examine Your Life Story & Inner Life
Cancer often becomes a major chapter in a person’s life story, but it is not the whole story. This retreat invites participants to gently examine the inner life of cancer: the fear, grief, anger, courage, tenderness, and questions that may not always have room to be spoken.
Through guided reflection and optional journaling, attendees will explore the difference between having cancer and being defined by cancer. The retreat helps participants honor what has been interrupted while also remembering what remains true about who they are. It gives space for honest emotions without forcing positivity or rushing toward acceptance.
Coaching Questions:
“What has cancer interrupted?”
“What has cancer revealed?”
“What part of me is still here, still mine, still untouched?”
“What do I wish people understood about my experience?”
________________________________________
September 10, 2026 – Still Me: Choosing Who I Want to Be in This Season
Strength for the Journey Theme: Become Your Best Self Through Intentional Living
This retreat centers on one of the most powerful questions a person facing cancer can ask: Who do I want to be while I am in this?
Cancer can take away plans, routines, energy, independence, confidence, and a sense of control. But it cannot take away the deeper freedom Viktor Frankl described: the freedom to choose one’s attitude and one’s way of meeting life. This retreat explores values-based living — acting from what matters most, even when life feels hard and the body feels unreliable.
Coaching Questions:
“What do I most want to be known for — by myself and by the people I love — in this season?”
“What word feels most like the truest version of me?”
“What is one small way I can live toward that word this week?”
________________________________________
October 5, 2026 – Letting Love Meet Me Here
Strength for the Journey Theme: Love Wholeheartedly
Cancer affects relationships. Some people show up beautifully. Some disappear. Some say the wrong thing. Some try to help but do not know how. Many people find themselves trying to protect everyone else emotionally while also carrying their own fear, pain, and exhaustion.
This retreat explores what it means to love and be loved in the middle of vulnerability. Participants will reflect on receiving help, asking for what they need, setting boundaries, having honest conversations, and allowing love to become simpler, more practical, and more present.
Coaching Questions:
“What kind of support actually helps me?”
“What am I tired of pretending is okay?”
“What conversation might bring more honesty, closeness, or relief?”
________________________________________
November 2, 2026 – Wisdom for the Hard Days
Strength for the Journey Theme: Live Wisely & Resiliently
Some days require courage. Other days require wisdom. This retreat focuses on emotional steadiness, self-compassion, energy management, scanxiety, uncertainty, and practical resilience for the hard days of cancer.
Rather than defining resilience as “staying strong,” this retreat reframes resilience as learning how to return to yourself again and again. Participants will explore the difference between what is theirs to carry and what is not, how to respond to fear without being ruled by it, and how to make wise choices when energy is limited.
Coaching Questions:
“What does my body need from me today?”
“What helps me come back to myself when fear rises?”
“What is one kind thing I can do for myself this week?”
________________________________________
December 7, 2026 – Meaning, Hope, and the Life Still in Front of You
Strength for the Journey Theme: Live with Purpose
Cancer often brings people face-to-face with the deepest questions: What matters now? What am I living for? What does hope mean when life feels uncertain? What legacy am I already leaving through the way I love?
This retreat is tender, honest, and meaning-centered. It does not define purpose as productivity. It does not define hope only as cure. Instead, it invites people to discover purpose in presence, love, courage, faith, beauty, gratitude, advocacy, relationships, and small acts of meaning.
Coaching Questions:
“What makes today meaningful, even if it is hard?”
“What kind of hope is still available to me?”
“What do I want to pass on — through my words, my presence, my faith, my courage, my tenderness?”
________________________________________
Location: Online, Zoom link provided upon registration.
Cost: Free of charge
Limited Spots Available- Reserve Your Spot Today for Loving Well in Cancer
Strength for the Journey Virtual Cancer Retreat July, 6 2026
Strength for the Journey Virtual Cancer Retreats with Dr Sharon May
July 6, 2026 from 3-3:45pm EST- Stay Rooted When Life Feels Uprooted
Strength for the Journey Theme: Stay Rooted in Your Faith and What Grounds You
Cancer can make life feel suddenly unstable. Appointments, scans, treatments, side effects, uncertainty, and changing plans can leave women feeling as though the ground beneath them has shifted. This retreat creates a gentle space to return to what still holds: faith, breath, prayer, scripture, values, trusted relationships, memories of strength, and the quiet presence of God. This retreats helps participants identify what they can return to when they feel afraid, overwhelmed, tired, or alone.
Coaching Questions:
“What grounds me when I do not have answers?”
“What truth can I return to today?”
“What helps me feel held, even when I do not feel strong?”
________________________________________
Location: Online, Zoom link provided upon registration.
Cost: Free of charge
Limited Spots Available- Reserve Your Spot Today!
Strength for the Journey Virtual Cancer Retreat August 17, 2026
Strength for the Journey Virtual Cancer Retreats with Dr Sharon May
August 17, 2026 from 3-3:45pm EST- My Story Is Still Mine
Strength for the Journey Theme: Examine Your Life Story & Inner Life
Cancer often becomes a major chapter in a person’s life story, but it is not the whole story. This retreat invites participants to gently examine the inner life of cancer: the fear, grief, anger, courage, tenderness, and questions that may not always have room to be spoken.
Through guided reflection and optional journaling, attendees will explore the difference between having cancer and being defined by cancer. The retreat helps participants honor what has been interrupted while also remembering what remains true about who they are. It gives space for honest emotions without forcing positivity or rushing toward acceptance.
Coaching Questions:
“What has cancer interrupted?”
“What has cancer revealed?”
“What part of me is still here, still mine, still untouched?”
“What do I wish people understood about my experience?”
________________________________________
Location: Online, Zoom link provided upon registration.
Cost: Free of charge
Limited Spots Available- Reserve Your Spot Today!
Strength for the Journey Virtual Cancer Retreat September 17, 2026
Strength for the Journey Virtual Cancer Retreats with Dr Sharon May
September 17, 2026 from 3-3:45pm EST- Still Me: Choosing Who I Want to Be in This Season
Strength for the Journey Theme: Become Your Best Self Through Intentional Living
This retreat centers on one of the most powerful questions a person facing cancer can ask: Who do I want to be while I am in this?
Cancer can take away plans, routines, energy, independence, confidence, and a sense of control. But it cannot take away the deeper freedom Viktor Frankl described: the freedom to choose one’s attitude and one’s way of meeting life. This retreat explores values-based living — acting from what matters most, even when life feels hard and the body feels unreliable.
Coaching Questions:
“What do I most want to be known for — by myself and by the people I love — in this season?”
“What word feels most like the truest version of me?”
“What is one small way I can live toward that word this week?”
________________________________________
Location: Online, Zoom link provided upon registration.
Cost: Free of charge
Limited Spots Available- Reserve Your Spot Today!
Strength for the Journey Virtual Cancer Retreat December 7, 2026
Strength for the Journey Virtual Cancer Retreats with Dr Sharon May
December 7, 2026 from 3-3:45pm EST– Meaning, Hope, and the Life Still in Front of You
Strength for the Journey Theme: Live with Purpose
Cancer often brings people face-to-face with the deepest questions: What matters now? What am I living for? What does hope mean when life feels uncertain? What legacy am I already leaving through the way I love?
This retreat is tender, honest, and meaning-centered. It does not define purpose as productivity. It does not define hope only as cure. Instead, it invites people to discover purpose in presence, love, courage, faith, beauty, gratitude, advocacy, relationships, and small acts of meaning.
Coaching Questions:
“What makes today meaningful, even if it is hard?”
“What kind of hope is still available to me?”
“What do I want to pass on — through my words, my presence, my faith, my courage, my tenderness?”
________________________________________
Location: Online, Zoom link provided upon registration.
Cost: Free of charge
Limited Spots Available- Reserve Your Spot Today!
Stage4Hope’s partnership with Bear Shadow Featured in Recent Article from MusicFestNews.com
As excitement builds for the upcoming Bear Shadow Music Festival, Stage4Hope is honored to be featured in a recent article from MusicFestNews.com highlighting our partnership with Bear Shadow and the meaningful mission behind it.
The article, “Music with a Mission: Bear Shadow Joins Forces with Stage4Hope,” shines a spotlight on how music and purpose can come together to create real impact for individuals and families facing cancer. We are grateful to MusicFestNews.com for helping amplify our mission and supporting those fighting cancer with compassion, connection, and hope.
Clinical Trial Hope for ROS1 Lung Cancer
Why ROS1 Patients Should Be Watching Zidesamtinib
For people living with ROS1-positive non-small cell lung cancer, Zidesamtinib is one of the most important new developments to watch. It is being studied in the ARROS-1 clinical trial, and public trial listings show Memorial Sloan Kettering Cancer Center and Emory Winship Cancer Institute as active sites.
This matters because clinical trials should not be treated as a last resort for ROS1 patients. In some cases, a trial may be worth discussing earlier, especially when side effects, quality of life, or long term planning are already becoming part of the treatment decision. ARROS-1 includes multiple patient groups, including some who are TKI-naïve (not previously treated with a ROS1 targeted drug), which reinforces that this is not only a trial for people who have run out of standard options.
Zidesamtinib for ROS1 Lung Cancer: New Trial Hope
What Is Zidesamtinib?
Zidesamtinib is a targeted medicine being studied for cancers driven by a ROS1 fusion, a specific gene change that can fuel cancer growth. It was designed to help address some of the hardest problems ROS1 patients face, including when earlier targeted drugs stop working and when cancer spreads to the brain. Public company materials also describe activity against certain ROS1 resistance mutations, including G2032R.
Zidesamtinib is not yet FDA approved, but it is moving through FDA review after encouraging trial results. Nuvalent has announced that the FDA accepted its New Drug Application for priority review, with a target action date of September 18, 2026.
Why Is It Getting So Much Attention?
Zidesamtinib has received FDA Breakthrough Therapy Designation for patients with ROS1-positive metastatic non-small cell lung cancer who have already been treated with 2 or more ROS1 targeted drugs. That does not mean the drug is already approved, but it does reflect the significance of the early data and can help speed development and review.
Early public results from ARROS-1 have also been encouraging in previously treated ROS1-positive lung cancer, including reported responses, durable benefit in many responders, and activity in patients with brain metastases and certain resistance mutations. These are still results from an ongoing study, but they are one reason many ROS1 patients and doctors are watching zidesamtinib closely.
Who Should Ask About This Trial?
ARROS-1 is not limited to one narrow patient group. According to the public trial listing, the Phase 2 portion includes patients who are TKI-naive, patients who have had 1 prior ROS1 inhibitor, patients who have had 1 prior ROS1 inhibitor plus platinum chemotherapy, patients who have had 2 or more prior ROS1 inhibitors, and a separate cohort for other advanced solid tumors with a ROS1 rearrangement.
That means this trial may be worth asking about in more than one situation. If you are newly diagnosed and TKI-naive, it may be worth discussing. If your current ROS1 treatment is still controlling your cancer but the side effects are significantly hurting your quality of life, it may also be worth discussing. For ROS1 patients, the right time to talk about a trial is not always after progression. Sometimes it is earlier, while there is still time to make a thoughtful decision.
Where Is It Available?
The main study is ARROS-1, an active Phase 1/2 trial listed by the National Cancer Institute. Public listings show both MSK and Winship as active locations.
MSK also lists a separate expanded access pathway for zidesamtinib for certain adults with advanced ROS1-positive cancers whose disease is still growing after treatment. That means some patients may have more than one path to ask about, depending on their situation and eligibility.
Why This Matters for ROS1 Patients
For ROS1-positive lung cancer, this is a real step forward.
The treatment landscape is still moving. New options are still being developed. Clinical trials may offer access to promising therapies earlier than many patients realize. That is why trial review should be part of the conversation for ROS1 patients, especially at leading cancer centers that see these cases often and understand the evolving science.
Too often, patients hear about trials only when they are running out of options. That is too late for some people. For ROS1 patients, the better question is not only, “What do I do after this stops working?” It is also, “Should I already be exploring what comes next?”
What To Do Next
If you or someone you love has ROS1-positive lung cancer, now is a good time to ask:
- Has full molecular testing been done and reviewed recently?
- Is my current treatment still the best fit for both cancer control and quality of life?
- Should a leading cancer center review my case now?
- Should a ROS1 clinical trial be part of my plan now, not later?
- Is ARROS-1 or another trial worth discussing?
At Stage4Hope, we help patients move faster toward leading cancer centers, clinical trial opportunities, and practical support. If distance is part of the challenge, our Travel Expense Grants may also help.
Have ROS1-positive lung cancer? Ask us about expert care, clinical trial options, and travel support.
Stage 4 Cancer: What to Do First
Stage 4 Cancer: What to Do First After Diagnosis
A new cancer diagnosis can make everything feel urgent. Most people are frightened, overwhelmed, and pushed to make decisions before they even understand all their options.
But the earliest days after diagnosis are not just about moving fast. They are about making sure you do not lose options by moving too fast in the wrong direction.
Just Diagnosed with Advanced Cancer? 5 Things to Do Before Starting Treatment
Here are five of the most important things to do before starting treatment.
1. Slow things down and get the right testing first
Do not rush into treatment, especially chemotherapy, before the right information is back.
In many advanced cancers, biomarker testing can affect first line treatment decisions. NCI explains that biomarker testing looks for genes, proteins, and other substances that may help doctors choose treatment, and it can identify changes that affect how certain cancer treatments work.
Ask whether both tissue testing and, when appropriate, blood-based testing have been ordered. If those results could change your first treatment, they should be reviewed before you commit to a plan.
That means the first question should not be, “How fast can I start chemo?” It should be:
“Has my cancer been fully tested so I know all of my treatment options first?”
2. Do not choose first treatment until all options are discussed
The first treatment often matters the most because it can shape what options remain later.
Clinical trial eligibility commonly depends in part on prior treatment history, along with cancer type, stage, biomarkers, and overall health. In other words, the treatment you start first can affect what you may qualify for next.
Before deciding, ask your doctor to review all appropriate options, including:
- targeted therapy
- immunotherapy
- chemotherapy
- clinical trials
Do not let urgency push you into chemotherapy before you understand whether another option should be considered first.
3. Ask about clinical trials early, not as a last resort
Many patients think clinical trials are only for people who have run out of options. That is not true. Some trials are available for patients who are newly diagnosed or who have not yet started treatment.
Clinical trials matter because some of the newest cancer drugs are available there first.
Many phase 1 cancer trials, especially for patients with advanced cancer, are dose escalation studies in which participants receive the investigational treatment at different dose levels while researchers study safety and dosing. Patients often worry that joining a clinical trial means getting a placebo and no treatment. In cancer trials, that fear is often misunderstood. NCI says placebos are rarely used in cancer clinical trials and that giving a placebo is not ethical when an effective treatment is available.
A better question to ask is:
“Should a clinical trial be considered before I start standard treatment?”
4. Get treated at, or at minimum get a second opinion from, a major cancer center
Do not assume the first local referral is the best or only option.
NCI-Designated Cancer Centers are recognized for scientific leadership in laboratory and clinical research, and these centers often provide disease-specific expertise, broader access to clinical trials, and treatment approaches that smaller institutions may not offer.
This matters because a major cancer center may see treatment opportunities that a smaller local practice does not.
Even if you ultimately receive treatment locally, getting a second opinion from an NCI designated or other major cancer center can be one of the most important steps you take. Many insurance plans do cover major cancer centers, although referral rules, prior authorizations, and network requirements vary by plan and should be checked quickly.
5. Get support early so you can make clearer decisions
A cancer diagnosis affects far more than the body. It affects how you think, how you sleep, how you process information, and how you handle fear.
That is one reason support matters early. Patients often need space to steady themselves emotionally so they can make informed decisions medically.
At Stage4Hope, we understand that the earliest days after diagnosis can feel like the hardest. That is why we offer Strength for the Journey, our therapist-led virtual support designed specifically for people facing advanced cancer, including Still Me, our program for those who are newly diagnosed.
You do not need to have everything figured out immediately. But you do deserve the chance to make decisions from a place of clarity, not panic.
After a Stage 4 diagnosis, everything can feel urgent. But the goal is not simply to start treatment fast.
The goal is to make sure you start the right treatment first.
Need help taking the next step?
Learn how Stage4Hope helps patients access leading cancer centers and second opinions faster.
Explore our therapist-led virtual support programs for people newly diagnosed with advanced cancer.
Learn how second opinions can save lives.














