The term “terminal” is not automatically synonymous with “Stage 4.” It generally describes a clinical situation where the disease progresses despite available treatments, significantly impacts organ function, and life expectancy becomes limited. Some Stage 4 patients remain stable for long periods, while others may become clinically fragile earlier. The goal of a terminal framework is not “giving up,” but aligning care goals: symptom control (breathlessness, pain), nutritional support, psychosocial care, and timely palliative integration. In many cases, active cancer-directed treatments may still continue if benefit outweighs burden. Ultimately, terminal status is defined more by disease trajectory and functional status than by stage label alone.