Twenty-two-year-old Kaylee Engle crumbled to the floor of a hospital hallway when she got the news.

She had just learned that her body was riddled with melanoma skin cancer that had spread to other parts of her body.

The Canadian had seven brain tumors, at least 18 in her liver, and at least 20 in each lung, plus two beside her heart, and tumors in her spine, lymph nodes and adrenal glands.

‘It’s so widespread – it’s everywhere,’ the Toronto-based nanny said.

In July 2023, she detected a single lump adjacent to her right breast, which she brushed off as ‘just a cyst.’

It looked more like an ingrown hair or an under-the-skin pimple.

But when Engle continued to find new lumps forming in different areas, she knew something was amiss.

Doctors discovered after an X-ray that the lumps were miniature tumors all over her body after cancerous skin cells had spread through her bloodstream to other organs.  

Looking back, other symptoms she brushed off were clearly linked: unintentional weight gain, nausea, vomiting, and fatigue.

At first, doctors at the urgent care also believed the lumps were relatively benign cysts.

But X-rays confirmed the worst: the melanoma had invaded her lungs, bones, and brain.

The odds of dying from the cancer are exponentially higher once it has spread to other parts of the body. 

Just one in five patients with stage 4 melanoma are still alive five years after being diagnosed.

But, not only is Engle still here two years later, her cancer has since stabilized and is no longer growing.

Engle began chemotherapy and immunotherapy treatments just a few days after her diagnosis in June 2023. 

‘Although my diagnosis is stage four and has spread almost everywhere, it still does not mean “terminal,”’ she said. 

‘Here I am in 2025, almost two years into my stage four diagnosis, with now so many options for treatment, and they have much more hope for prolonging my life.’

As of May 2025, she has received 18 rounds of an immunotherapy drug called Nivolumab.

Engle started dual immunotherapy but stopped after two doses due to autoimmune hepatitis—a condition where the immune system attacks the liver, causing inflammation and potential damage 

After getting over her hepatitis, in addition to radiation treatments for tumors in her brain and eyes, Engle continued a regimen of nivolumab alone.  

But it’ll be a constant fight for rest of her life type thing

‘Likely I could be in treatment for the rest of my life, but there are cases of people with NED (no evidence of disease),’ she added.

Until learning her devastating diagnosis, Engle was a healthy young woman. 

Doctors had, over the years, removed several benign moles out of an abundance of caution.  

Moles are groupings of normal melanin-forming cells. But damage to the DNA of those cells, often through heavy exposure to UV rays, can cause skin cancer.

Cancer cells can then break away from the original tumor and enter the lymphatic system, a network of vessels throughout the body, and the bloodstream, where they can multiply and form more tumors, which were the lumps all over Engle’s body.

‘By the time I was diagnosed, I was [already] convinced I had cancer, but even so, finding out for sure was a shock,’ she said.

‘But it felt validating that I knew something was wrong with my body.’

She faced a bumpy road in trying to find the cancer treatment that worked for her, including her bout of autoimmune hepatitis. 

‘My girlfriend and I were out shopping when I got a call from my oncologist who said my liver ALT numbers were very high – normally they should be under 50, and mine were up to 500.’

‘They said I needed to go to the hospital immediately for IV steroids, which I got every day for a week or so to bring the numbers down and then could eventually start treatment again once they were.’

She had to take a break from treatment again in October 2024 when she began suffering breathing trouble. 

Given the 20 tumors in each lung and the immunotherapy she was taking, doctors first feared it was a case of pneumonitis, or swelling of her lung tissues.

Luckily, it was not, and doctors concluded that the life-sustaining drugs she was taking were not the cause. Rather, it was likely a result of the cancerous tumors in her lungs. 

But she was placed on the steroid prednisone for months, infamous for its side effects, including agitation, ‘moon face’, and swelling elsewhere in the body.

Toronto is a hub for medical innovation, allowing Engle access to the most cutting-edge treatments.

She will soon undergo a blood test that will screen for specific indications like tumor mutations or immune markers, which will determine whether she is suitable for Tumor-Infiltrating Lymphocyte therapy (TIL).

It uses her own immune cells found within her tumors, which are extracted and taken to a lab where scientists isolate a mix of immune cells – mostly T cells – that had infiltrated the tumors but were overtaken by the cancer.

The scientists then multiply them exponentially and place them in bioreactors that infuse them with nutrients and growth factors, creating an army of immune cells that are reinfused into Engle’s body.

She said: ‘[It] isn’t approved in Canada yet, but the US drug company has agreed for me to get compassionate treatment here before it’s approved for trial in Canada, which will be done by my oncologist.

‘My oncologist thinks it could be an amazing option and I could likely continue my immunotherapy afterwards if needed!’

Her future remains uncertain. 

Advances in immunotherapy and highly targeted therapies have accelerated over the past decade, with promising evidence that they can shrink tumors, extend survival, and, in some cases, achieve long-term remission from advanced cancer.

‘I will try anything to let me live a full life,’ she said.

‘But I’m just enjoying every day as much as I can and I have a lot of hope for the future, whether that be treatment ongoing, or becoming cancer free, which is the ideal goal for me – and which I know I can achieve eventually.’

A mole that becomes itchy, painful or tender should not be ignored. Additionally, moles that ‘bleed, become sore, or start to weep fluid’ are alarming signs.

Key warning signs of a potentially cancerous mole include rapid growth, color changes, and irregular shape. 

A mole that grows noticeably within weeks, develops multiple or uneven colors (such as brown, black, red, white, or blue), or becomes asymmetrical should be evaluated by a doctor, as these changes may indicate skin cancer. 

Thirty percent of melanoma cases starts in moles, but there are a small percentage of cases that can’t be traced back to one site. 

The American Cancer Society estimates that nearly 105,000 cases of melanoma will be diagnosed in 2024, and roughly four percent will be stage four.  

Melanoma kills more than 8,300 Americans each year, according to the Melanoma Research Foundation (MRF), but about 90 percent of cases are considered to be preventable through vigilance about sun safety. 

The average age of diagnosis is 63 years old.

However, melanoma is one of the most common cancers in people under 30, and has been increasing ‘dramatically’ over the past three decades, according to Cleveland Clinic.