Sister's Cancer; Please Answer!

dear PPL,
I hope your sister is comfortable at present. I agree with the person who thought that renal failure might be one type of direction she goes in, however that also encompasses so many other systems, that it is best to just take each day and each symptom as it comes and deal with it at that time. Sometimes you can worry so much about certain symptoms or problems that might be a possibility and they actually never occur.
I do want to really emphasize that our hospice group has managed to make even the most complex patients quite comfortable on sub-lingual liquid meds such as morphine and oxycodone, which are used when a patient can no longer swallow or take their usual meds by mouth. These come in liquid, highly concentrated forms, 20mg per ml, and use an eyedropper delivery, and are given as I mentioned s/l or buccally in the cheek. They really can provide excellent comfort to the majority of patients. There really are only a few circumstances, for example, if a patient has nerve pain or bone pain, or pain that has not responded to these meds after a reasonable trial and titration up to higher doses, then a sub-cut., IV or epidural pump might be used. If a patient has pain that has been well managed with opiates orally, there is no reason to worry about staying with the sub-lingual morphine or oxycodone.
Sometimes patients and families worry that an IV or other infusion is the only way to make someone comfortable, and that is just not actually true. But that misconception can prevent a patient from experiencing comfort and confidence in their pain management regime, so I tell you this in order to help you feel more secure if your Hospice nurse elects to use the sublingual meds first, as I am sure he or she will.
What you are going through is hard and painful, but I promise you there are so many gifts within the process, for you and your loved ones. Allow yourself to see these things and experience them fully.
God Bless.

Dear PPL,
I am new to this format, so I may not be very adept at following the computer things, but I have not seen any posts from you since December 29. I am worried that things have changed for you and your family, although certainly I can hope that things are also stabilized and you are all okay. I have thought of you so much, and hoped that you are all doing okay no matter how it has turned out. Many thoughts and prayers are sent your way. God bless.

I think your sister was very lucky to have such loving family members see her through right to the end of her life. My thoughts are with you and your family PPL.

I read these postings with tears in my eyes. I myself have been recently diagnosed with breast cancer. I am 39 years old. I have an excellent prognosis--mastectomy, no lymph node involvement, chemo.... and less than a 3% risk of recurrence.

However, after just three chemo treatments with adriamycin, cytoxan, I can tell you that I understand your sisters' decisions NOT to continue with treatment. I have never felt as much intense discomfort at the 72 hours following those treatments. Then you never feel good.

I have two children (16 and 10). If it wasn't for them, I would opt for no treatment and take my 20% recurrence risk. I have a strong, strong believe in an eternity without pain, discomfort, hurt. Why would I choose to postpone it? Well, my only reason is my daughters. But I can see that if this drug on for years, I would lose that "selflessness".

Both of you are in my prayers.

Betty