When people talk about cancer, the story almost always centers on survivorship. There’s a beginning, a middle, and an end. A diagnosis, a battle, and a victory. Survivors ring bells, declare themselves warriors who “beat cancer,” and step back into a version of normal life. Yes, there’s fear of recurrence. Yes, there ay be follow-up scans every six months or a year if something doesn’t feel right. Yes, there may be medications with side effects—but for most, those meds have a finish line, often five years down the road.

Stage IV is different.

There is no finish line. There is no “last day of treatment.” There is no bell to ring. Cancer doesn’t leave; it moves in. It’s not something you beat—it’s something you live with. Sometimes it quiets down, sometimes it flares up, but it is always there.

Stage IV means:

Infusions that don’t end. Scans more often. Constant blood work watching white blood cell counts and tumor markers. Stopping and starting meds because your body can’t handle it and the fear that everything will get out of control, and sometimes it does. Medications that are lifelong, not temporary. Radiation to stop growth on occasion. Exhaustion that never fully lifts. The knowledge that cancer is not a visitor that might come back—it already has.

For survivors, the narrative is one of triumph: “I fought and I won.” For those of us living with Stage IV, the narrative is different. It’s about endurance. Adaptation. Learning how to carry cancer alongside life, even when the load feels unbearable. Sometimes the disease wins ground. Sometimes it’s held in control. But it never leaves the room.

This isn’t about minimizing what early-stage survivors go through—their fight is real. But the lived reality of Stage IV is different. It’s not about beating cancer once and for all. It’s about learning to live fully while cancer stays.