What happens when cancer takes you??

Trauma Columnist · Jan 24, 2006

Hospice is actually for anyone with a one year life expectancy so you can certainly arrange for hospice way prior to the last few weeks. As to what to expect - its difficult and very individual. Many factors influence this: the patient's age, type of cancer, other illnesses, their understanding of the illness, etc. Take care...if I remember correctly, one of your family members has cancer? I'm so sorry.

Daytonite, BSN, RN · Jan 24, 2006

You should do some reading on lung cancer and it's progression when left untreated. What I have seen is that the tumor spreads throughout the lung making breathing progressively more difficult. There is less and less functioning lung tissue for oxgygen to be taken in and perfuse. There is often confusion and shortness of breath at the very end because of the oxygenation problems. The person will need to be on supplemental oxygen and will have to be in elevated positions to help with breathing. Then, of course, there are the systemic effects of the disease as well as the issue of metastasis. Other symptoms may arise because of where the cancer has metastasized. Patients tend to get cachetic looking and develop a pasty or grayish skin coloring. Patients lose weight rapidly because of the tremendous amount of energy required by the tumor cells that are continuing to reproduce, only there are now more and more of them. Hospice can be called in as soon as the patient starts to need nursing assistance and medical equipment. A doctor must order all these things.

leslie :-D · Jan 24, 2006

Can anyone tell me?
When cancer cannot be treated....all treatments have failed.....what happens at the end of life with widespread CA? What is the general process, specifically with a lung tumor left to get larger and larger?
I want to know what to expect in the last few weeks of life?
When do you start arranging hospice?
Thanks!

first i would get an estimation of how much time is left from the md.

if the pt is symptomatic, or the family is struggling then contact hospice now.

they can and will effectively manage any s/s that come along the way.

if the person is eligible, i would contact hospice now.

i'm very very sorry.

leslie

Curious1alwys, BSN, RN · Jan 25, 2006

Thank you for the information. Yes, I do have cancer in my family. Small cell lung. That is why I did not know if it would progress like regular lung CA since my father's tumor is outside of his lung (well, in the pleural space). However, they did a few rounds of chemo and he now has a new tumor in his other lung that grew despite the first chemo regimens. Now he is getting himcamtin (sp)(topotecan) for five days strait. I don't know if this means he has "relapsed" despite chemo. I know it now means this is second line treatment??? He is chemo sensitive? I think this is a big problem with this type of cancer, part of the reason it kills so fast.

Anyway, I have never had CA in my family and don't know what to expect. He is losing weight now though and if the chemo doesn't work, I suppose we should expect pulmonary sx related to the tumor that is growing out of control. The other tumors shrunk by 50%. His brain lesions are to be evaluated in another month or so I believe.

Thanks to those who responded!

CHATSDALE · Jan 25, 2006

this is a rough time..my thoughts and prayers are with you

Fonenurse · Jan 25, 2006

You might find this link helpful http://www.cancerbacup.org.uk/Cancertype/Lung however it is a UK site - so you will need to check with the patient's MD about treatment choices etc as things are different in the states (with different drug names etc).

I am sorry to hear that you and your family need this info - all best wishes for everything...

BabyRN2Be · Jan 25, 2006

I'm so very sorry that you are having to deal with this. My thoughts and prayers are with you.

Find out how long this person has left. Hospice can be called when the person has a life expectancy of less than 6mo to a year.

I wish peace for your family at this time.

donsterRN, ASN, BSN · Jan 25, 2006

I, too, am very sorry about what's happening. You and your family are in my thoughts and prayers.

mtnmom · Jan 25, 2006

I am so sorry you are having to deal with this. (((((hugs)))))

The other posters have given you a pretty good description. At the very end there is a gradual shutting down and slowing down. Pain and symptom management is the key. This is where hospice care can really help.

If your father is still cognizant, try talking to him about his feelings. I remember when my Mother in law (who I was very close to) was dying of cancer...one day we were talking, just the two of us, and she admitted that she was afraid. I was a bit surprised at the time b/c she was a woman of very strong religious faith, and just an all-around strong person. Once she admitted that, though, we talked about it and she said that it made her feel better to verbalize those feelings.

also find out his wishes for end of life care and for funeral arrangements, etc if he has not already specified. Make sure that he has a living will.

Also this is the time to conference with other family members about their feelings. Every family, and every family member, has different ways of coping.

you will all need one another in the coming weeks and months, so lay aside any petty differences and make peace. And if there are young children in the family, you would be surprised at what they notice. Make sure that they are given as much explanation as is appropriate for their age level.

Lastly, if neighbors or friends offer assistance...take it!!! Whether its meals, childcare, errands, etc....they would not offer if they did not want to help. If someone asks "is there something I can do"...then let them know what your needs are.

Sorry this is long. It is based on personal experience. My prayers are with you.

Curious1alwys, BSN, RN · Jan 25, 2006

Thank you.:flowersfo

It is so hard to "talk" with my Dad. We never had the best of relationships...not really the talky kind, you know? I ask him how his feeling and stuff like that but to start talking about whether he is afraid or not is very hard...I think for me and for him. What sorts of things can I say???

All my life my Dad was extremely manipulative and very self centered due to poss. mental illness as well as longstanding addiction. Therefore, we never really bonded like father and daughter sometimes do. I feel like I just don't know what to say, and sadly, sometimes I find myself wondering if he is acting as if he is in more pain than he is (he is taking all the pain meds he can get). I am trying to see that that should not matter now, trying to look past that. Recognize that he likely does not have much time left and act accordingly.

Can you help me with things I can do/say that will convey how much I care for him? I tell him all the time I love him, but it feels more routine. I'd like to do something really special. Any ideas??

Indy, LPN, LVN · Jan 26, 2006

Unfortunately, the best thing you can do, is probably the hardest, and that is to open up and talk.

My heart goes out to you.