Need info. Mom has stage IV lung cancer. (x-rays, painful, blood tests)

[Pikantari]

hello Cecilia. My mother had what is called Small Cell Lung Carcinoma. This is an inoperable cancer.

She started out with COPD, and emphysema. It was devestating just to hear that she needed to be on O2 for the rest of her life, and if she didn't get on it, not much longer would she be around.

Then the dx came, the one of Cancer.

My mother opted to be on chemotherapy, at 64. She was on it for 13 months, and finally one day, she decided to come off of it. She died a month later.

Her life diminished on chemo. There was no quality at all. She was given some quantity, but that quantity was not even worth the pain she went thru during all of it. It was not even worth it.

Then the one month she did have on it was not quality. Had she opted this choice in the begining, I think she actually may have had some quality.

My mothers cancer spread to her liver and kidney, in the form of tumors. It went to her bones, causing so much pain, and finally, to her brain. That month she had with no chemo, was a month that she was not herself. Yelling out profanities, not knowing us, not knowing herself. The cancer taking her farther than any of us wanted it to.

I continued to care for her and for about the last week of her life, she was coomatose, a few words that made no sense at all coming out.

Things that were from her younger days, mixed with things from her older years...

I think the only reason she chose the chemo route... was that she was afraid of dying. She wanted to give us more time with her, and she had one more thing to accomlish before dying. I tried to help her do it, but I couldn't.

The task to hard, not enough information in this huge world could she give me to find out what she wanted to know for my brother.

Yes. The chemo is a prolonging mechanism, but the quality of life is so poor.

I was glad she chose it in the beginning, just hope for a little more time with my mother, after having lost my Dad to cancer as well, in a quick manner, no time to hardly say good bye for him.

But that time, it was terrible for her. And when she finally chose to end it, it was to late for any quality of life. It was gone, and not even a distinct possibility.

[fuzzymystic]

Not to be harsh, but with your mom being 79 and having emphysema and being diabetic, a prognosis of six months to a year might be all the time she has left anyway. Just make sure that she knows you will abide by her wishes whichever way she chooses to go. My mom was diagnosed in May 06, and the chemotherapy just ravaged her, my sister was diagnosed in Feb. of last year. The doctor told my sister 6 months-well, this was inconceivable to me-my baby sister, and my mom? My sister died in August, my mom died less than a month later. I wonder if either one would have foregone the horrendous side affects of their treatments to have the quality, vs the quantity.
Does your mom live alone? Look into the [up here it is called] 'area office on aging', see what is available in order to help your mom with her day to day life. Look into hospice-home hospice can do a lot of things, help the family, and get a routine worked out that will make things run smoother in the household. They will sometimes suggest putting the person into a rehab/nursing home, temporarily, just to help them with physical therapy type of things, such as you mentioned, her falling. The hospice people will let her have what elston so perfectly stated, dignity while she is going through this process.

[Cecilia_Rose]

Sorry its taken me so long to answer. Thanks for all your candid remarks. I really need some straight answers. I dont have time for sympathy right now.

Truthfully Im not so sure the chemo is a good choice either. But shes not senile so it should be her decision. The problem is Im not sure shes listening. Everytime we go to a Dr she wants to complain about stupid stuff like things the neighbors dog did or things her brother did to her when they were kids. When I interupt her to get back on track she yells at me. Stop interupting me. Im talking.

I think Mom is okay with the nursing home now that she sees its not the horrible place she thought it would be. But she still plans on comimg home. Im sure thats the ONLY reason shes doing her rehab exercises. I feel sorry for them . Shes giving the aides HELL. She rings the buzzer every 15 min.


And no she cant stay with me. I live in an old farm house. The bedrooms and bath are upstairs. We had help from the Ofc on Aging so she could live in her own home. Meals on Wheels and an aide 3 hrs a day 5 days a week. But she requires 24 hr care right now and neither of us can afford it. . She has nothing but her SS and a tiny pension. I cant help much. Im an only child and I alone. Her only brother and my Gram just died. Im barely making it myself. If I dont work I dont get paid.

And to be honest. I dont think I could handle it. I helped take care of my husbands Gram and her two sisters before they died. They all three had alzheimers. Then until they died I helped care for my Uncle and my Gram. My husband is in jail and now hes in the hospital with heart problems. Moms never been a pleasant person to be around even under normal circumstances.

[Cecilia_Rose]

Originally Posted by elston

Is your mother able to participate in the decision making regarding her health care? If so, I would suggest you ask the doctor to meet with you and her to review prognosis and her options and quality of life expectations. With her other conditions and the stage IV cancer, there is a great deal to consider.

If I were her, I would want to consider, directives that specifically addressed the type of treatment I did and did not want; when appropriate I would also want to discuss hospice care with my physcian. I would rather spend a few months at home dying with dignity than several years in facilities, dying but surronded by strangers and equipment and pain and extended discomfort.

I know this may sound insensitive, but if it were me........

My prayers are with your mother and your family. I would reassure that "we are held in a love greater than we can ever know"; I so believe that to be true, even in these circumstances.

No you dont sound insensitive. Thanks for the info and your support. This is what I want. Straight answers. I agree wth everything you posted. If it were me.... But she wants everything.

We already met with the Drs. Her only options are chemo or nothing. With nothing she has 6 mo to a yr. He doesnt guarantee anything with chemo.

[Miss Blue]

Cecillia..If your mom is okay with the nursing home, by all means let her be there..She will be under 24 hour care and will be safe..Mom sounds like she may be in just a little bit of denial. by pretending not to hear and her constant changing the subject, and a little anger too..You may have to be firm and tell her she is in charge, but has to make the decisions now about the Chemo or the nursing home..You will just have to tell her or let the Dr tell her that she cannot stay alone and will require more and more attention as the days go by and she really needs to start planning or allow you to do it for her..Maybe you and her could come to an agreement that you will take her home now and then when you are off work, and you two can just enjoy being home alone for a few hours..That way I think she will have something to look forward to until she becomes too ill to care..Sorry I sound a little cold, but this advice is given in love and concern for both of you..

[jfc]

My father died of Metastic Bowel cancer that spread to his bladder on 2nd December 2007. He was also 79.

He tried chemotherapy, radiotherapy, surgery (twice..once to remove part of his bowel and bladder, then again to remove the remainder of his bowel and fit him with an illieostomy bag).

Pallative care in the end was a much better alternative to contiuning with his gruelling treatment. But it was his choice and thats important.

He was nursed at home mainly by family but in the end we had 3 nights of Marie Curie cancer nurses to administer morphine injections. He spent the remaining 5 days of his life in a hospice. The staff were wonderful, not only to my dad, but also to my mum, myself, my sister and the grandchildren. We were all welcomed to help care for him, but in the knowledge my dad was kept pain free and comfortable.

My heart goes out to you and your mum at this time, take some time to think this through and talk to your mum about all her options.

xx

[anifani821]

I am gonna weigh in, too. Having had a family member w/ stage 4 lung cancer . . . and my best friend (70 at the time) - liver cancer wh/ metastasized . . . I agree w/ what elston (and others) have written.

At the end of her life, my friend told me she wished she had NOT gone thru/ all the treatments, as it affected the quality of her life and did nothing to mitigate the spread of her cancer.

I know this is a very difficult time for your family . . . and so I am saying a prayer . . . and sending my best wishes . . .

[christina0001]

I've seen several people suffer with lung cancer, and many through other cancers. IMO the treatment will debilitate her, to a point where she won't have much of a quality of life. Do the therapy for now, hopefully it will strengthen her and perhaps improve things a bit. But when it gets to the point when the therapy isn't helping, and it's just too much to do, I would strongly consider hospice. Lung cancer can be very...uncomfortable, and I think the best thing to hope for is that your mother be as comfortable as possible.

I understand about not being able to bring mom home, too. I have worked home care, and now I work in a nursing home. Home care, when the family is able to help, is almost always the best option. But most of us are not blessed with family members who are willing and able to help us 24/7.

[nay624]

Cecilia. My deepest sympathies....I am an ICU nurse. My grandmother was diagnosed with lung cancer and she passed 6 weeks later. She was in fair-good health, used to smoke, did yoga 3x/day. She had mets to the brain and liver.. The Chemo hastened the enivitable. she died 1 week after her first treatment. Here are some things I feel you need to focus on (sorry for the obvious/bluntness)
Your mom will die, soon......sooner than you are prepared for.
Know what your mom wants. Spend as much time with her as you are able to.
Even if your mom is completely alert and oriented at this time, there will come a time when she cant make decisions for herself. This is where an Advanced Directive comes in. get one. talk it over with mom. have her sign it. know what she wants. so when the time comes you can make the right choices for her. ie does she want to be on life support? does she want to have dialysis?? does she want to live with feeding tubes and breathing tubes?? does she want cpr and to be shocked if her heart stops??
Let her know that whatever her wish is...YOU will be there to make it so.
This may not be easy to do for you and for your mom. dont rush her.

I hope I dont sound mechanical. I see far too often people left on life support who did not want it, on machines cuz the family doesn't know what to do. My point is this. have a game plan. regardless of the chemo option.

there are may senarios but 2 come to mind. either with or without chemo, the body deterioriates with cancer. #1 mom is comfortable, at home or in the nursing home, and nature takes its course, she does not have to be in pain. there are comfort measures available to "let her go" peacefully, when the time comes. this may eve take place in a hospital where there are higher skilled care givers, hospice as well.
#2 mom wants everything done. she may end up on a respirator with a tube into her mouth to her lung ( very uncomfortable and usually requiring heavy sedation to achieve comfort). tubes either into her belly or nose to feed her a milkshake continually( belly not to uncomfortable, nose very comfortable) and major iv access usually into a femoral or jugular/subclavian vein. ( to give all the medications her arm veins cant handle)
still she will be comfortable with medications.

Please please dont think Im cruel. I want you to know the worst and get the best of the end-of-life cycle. My grandmother chose for nothing to be done, she still suffered but was on pain medications continually dripping into her vein. She did not want to be "kept" here. Please know it is your choice and your mothers ( along with the physicians). This, in short, is what I tell my patients families. ( of course not in a few paragraphs).

Embrace her now, I believe in some way this is a gift of time, as cruel as it may be, you can choose to make the most of the time you have left. As for your mom not listening to
the doctors....she knows. she wants to be comfortable now! so the most pressing of issues are voiced. and that is her way of dealing, accepting the end of her life.
I wish the very best for you and your mother, may you have blessed days ahead and may the decisions you both make together be blessed as well.

[brokencrayola]

I am sorry your mother is ill. At her age I think quality of life is important. Chemo will likely make her very ill, lose her hair and greatly lower her resistance to illness. If it were me I would rather have 6 mos-1 yr. of time not attached to an iv in a hospital and ill and spend that time with my friends and family and enjoying what time I had left.