Forever Stage IV

By Millie Lintell

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Book Review: A Hopeful Rebellion Against Stage IV ALK+ Lung Cancer and the Untold Potential of Gallium Maltolate

In Chapter 4 of Forever Stage IV, the memoir takes a pivotal turn—one that feels both deeply personal and quietly revolutionary. The author, diagnosed with ALK-positive (ALK+) non-small cell lung cancer, reveals that her cancer had already metastasized to her brain at the time of diagnosis. The stakes couldn't be higher—Stage 4 terminal cancer, spreading to her brain, all while she navigates endless paperwork and insurance delays. Yet, Millie does not dwell in despair. Instead, it highlights an intelligent and deeply courageous decision—to take her fate, and her treatment, into her own hands.

Before considering chemotherapy, radiation, or targeted therapy, the author turned to a compound almost no one had heard of Gallium Maltolate*. This wasn't a random desperate gamble. It was a decision made in the margins of medicine, informed by scientific research and propelled by urgency. Gallium Maltolate, an investigational drug still in clinical trials, became her only lifeline—and what followed, she believes, changed everything. 

 

*Note: The inventor of Gallium Maltolate is Dr. Lawrence R. Bernstein. He developed this compound to overcome the limitations of earlier gallium-based cancer treatments, particularly Citrated Gallium Nitrate (Granite), which had to be given intravenously as it was poorly absorbed when taken orally. Granite was approved by the FDA in 1991.

 


Gallium Maltolate: A Primer on the Science

Unlike the conventional cancer drugs most patients are familiar with, Gallium Maltolate is neither a traditional chemotherapeutic agent, nor a monoclonal antibody, nor an immunotherapy. It is a small-molecule compound that delivers gallium—a metal element—bound to maltol, a naturally occurring sugar-like compound found in foods like roasted malt, chicory, and pine. This binding makes gallium bioavailable when taken orally, a critical improvement over earlier gallium compounds like citrated gallium nitrate, which had to be delivered via slow IV infusion over five days and carried the risk of kidney toxicity.

But what truly sets Gallium Maltolate apart is its mechanism of action. Gallium behaves similarly to ferric iron (Fe³⁺) in biological systems. Cancer cells, particularly aggressive ones, have an abnormally high demand for iron due to their rapid division and metabolism. These cells overexpress transferrin receptors to capture more iron, which is crucial for DNA synthesis and proliferation.

Gallium, once in the bloodstream, is mistaken for iron. Cancer cells eagerly absorb it—but unlike iron, gallium cannot be reduced to the ferrous (Fe²⁺) form, which is necessary for biological function. Once inside the cell, it blocks iron-dependent enzymes like ribonucleotide reductase, halting DNA replication and leading to cancer cell death. Crucially, healthy cells are less affected, as they rely far less on iron intake due to efficient recycling mechanisms.

This elegant trick—starving cancer by mimicking its most vital resource—offers a potentially less toxic, more targeted alternative or complement to traditional therapies. Yet, despite promising preclinical research, Gallium Maltolate has remained largely in the shadows of mainstream oncology.

 
A Personal Clinical Trial: Gallium Maltolate as a First-Line Approach

Back in her own story, the author begins taking Gallium Maltolate within a week of her diagnosis. She mixes it with water and drinks it each morning, calling it the only proactive thing she could do while mired in red tape. But this wasn’t Gallium alone—she also committed to a radical diet, one designed to enhance the treatment’s efficacy by removing iron and inflammation-promoting foods from her system.

She eliminated:

  • All meats (except occasional fish or chicken)
  • Red and green vegetables (to avoid iron-rich plant foods)
  • Coffee
  • Dairy products
  • Tomato-based products
  • Sugar (except fruit and occasional honey)
  • Alcohol
  • Processed foods

 

She switched to high-alkaline water and tea, creating an internal environment she hoped would further starve the cancer and support her body’s detoxification and healing mechanisms.

The early results were astonishing. At a follow-up with her pulmonologist, expecting to discuss installing a catheter to drain persistent pleural fluid from her lungs, she received unexpected news: the pleural effusion was nearly gone, and her lung had re-inflated. The doctor, surprised but pleased, told her he wouldn’t need to see her again. It was her first medical confirmation that something was working.

Then came the real shock: during her Gamma Knife procedure—a highly targeted form of radiation used to treat brain metastases—the MRI revealed that the malignant brain lesions were no longer present. Only a benign growth remained. The neurosurgeon was visibly confused, asking her directly: “What happened?” Still recovering from sedation and the bizarre weight of the metal frame screwed into her skull, she could barely respond. “Gallium?” she said quietly.

 
A Science the Oncology World is Overlooking?

The author is quick to acknowledge that Gallium Maltolate is not a miracle drug—and she does not recommend that others abandon standard treatment. But her experience raises difficult questions: Why has Gallium Maltolate remained so obscure in the oncology community? Why aren’t more trials being run? Why is a therapy with strong preclinical evidence still flying under the radar?

Research has shown that oral Gallium Maltolate has potential efficacy in a range of cancers:

  • Glioblastoma and other brain tumors
  • Lymphomas
  • Hepatocellular carcinoma (liver cancer)
  • Breast, prostate, lung, bladder, and colorectal cancers

 

Studies in animal models have demonstrated both safety and anti-tumor activity. Anecdotal human evidence—like the author’s story—suggests that early intervention with Gallium Maltolate might have benefits beyond what conventional treatment alone can offer, particularly when paired with careful dietary protocols.

Even its diagnostic cousin, Gallium-67, has long been used in nuclear medicine to locate and stage cancer, taking advantage of cancer cells' iron-hunger. The therapeutic logic, then, is not speculative—it’s a natural extension of existing clinical knowledge.


Conclusion: A Story That Demands Attention

Forever Stage IV is many things: a deeply personal account of facing death with courage, a raw and moving narrative of bodily resilience, and a sharply informed argument for medical curiosity. It is also a call to action—for patients, caregivers, researchers, and physicians—to take another look at what might be hiding in plain sight. Gallium Maltolate may not be a miracle cure, but in the author’s case, it was a lifeline—and perhaps, a game-changer.

Millie's story reminds us that in the war against cancer, progress isn’t only measured in FDA approvals or big pharma breakthroughs. Sometimes, it’s found in the quiet resolve of one patient who refuses to wait.