baffling but great news

icedyaria · Regular Joined: 24 Oct 2008 Posts: 22

my future mother-in-law, who has stage iv with liver metastases, just finished a round of chemo and apparently one of the metastases on the liver is gone now. we were told to expect her not to see another christmas. i am confused by this new development. does this mean that she might not die soon and may have years to live? could she even be cured?

rmdpanah · New User Joined: 15 Feb 2009 Posts: 6 Location: Canada

Hi icedyaria

It's good news to hear that she's responded well to the liver. However, from my understanding, when one is diagnosed with stage four it means that it has metastasized to other areas (some visible and some not). The cancer had travelled to the liver via the bloodstream and chances are it has already spread to other areas as well (my father has the same diagnosis). However, all of this is good news meaning that your mother-in-law's remaining time has extended and could have a few more months and god willing year ahead. In terms of cure, I have heard of individuals becoming candidates for surgery if the doctor has reason to believe that the cancer is once again controlled within the pancreas. I suggest you discuss this option with the doctor and see what he/she says. Honestly, don't be afraid to ask questions. Hope that helps and I wish you strength and courage through these times.

wannaknow · Senior User Joined: 19 Oct 2007 Posts: 118

icedyaria:
From what I've seen, Chemo is definitely not a science and if you have a good oncologist it can be an art which is great. But too many just throw Chemo at it with their fingers crossed behind their backs.

In my Mother's case, the more specific the questions about the Chemo or the cancer - the more vague & evasive the oncologist answers. Ok, I will not go any further.

To your point = tumor reaction to Chemo.

My Mother has 3 growths (1 yr after resection ) that we know of based on CT scan. She did 2 rounds of Gemzar & Xeloda. One growth shrunk during both rounds 44% & 41% respectively or 66% in total.

However, another growth grew 115% and the other grew by 30%

The oncologist reaction after reviewing the latest CT scan results = "looks good", HUH???? that's all he said. BTW my Mom (82+) has decided to stop chemo due to the side effects...........we are going for quality vs quantity.

icedyaria · Regular Joined: 24 Oct 2008 Posts: 22

my mother in law was taken to hospital today as she is in pain and unable to eat. after the success of her last chemo, the doctors decided to take a break from chemo for a while.
my fiance is thinking about coming home and we are wondering what will happen now. i now this is incredibly morbid, but what exactly can we expect at this point? guesses welcome, i know it's not a science.
many thanks,

yaria

wannaknow · Senior User Joined: 19 Oct 2007 Posts: 118

icedyaria:
Since 3 months have passed since your original post - a lot can happen in that time.
A few open questions:
1) When did the oncologist decide to give the chemo "break"?
2) The success = was that in Feb mentioned above?

I will tell you based on my experience that not eating is not a good sign but I'm sure you figured that one out. Neither is pain.

When was the last time they did a scan?

I agree with the advice from rmdpanah = corner the oncologist & also the attending Dr and ask away..........read what they say, don't say & their body language. This is not the time to be passive (not saying you are) - this is time for assertive pointed questions especially if the doctors are not forth coming.
In my Mom's case - they kept saying = she has Pancreatic cancer but it was hard to get answers on the secondary issues that were affecting blood counts, digestive tract, etc. It became a merry go round chasing various symptoms.
Good Luck & fingers crossed for your MIL & family.

icedyaria · Regular Joined: 24 Oct 2008 Posts: 22

well, i am sad to say that i am not in fact on speaking terms with my future MIL, though i am worried about her, obviously. so there are a lot of questions i cannot ask. my fiance's family don't ask many questions, they don't want to know, but i need to know what i will have to help him through.

anyway, the last round of chemo finished on april 7th, my fiance then saw his mother in the week following the 23rd, when she was already having trouble eating. she had also lost a lot of weight.

she was admitted to hospital yesterday and has since received pain medication. she is no longer in pain, but still cannot eat.

so my question is: will she get better from this, or have we now entered the 'dying'-phase? i am sorry if i sound callous, but i am trying to keep an emotional distance, especially after it was made clear to me by my fiance's family that my concern was not appreciated. i am now mostly worried about the effect on my fiance.

please give me some idea of what to expect now.

many thanks,

yaria

wannaknow · Senior User Joined: 19 Oct 2007 Posts: 118

icedyaria:
OK - got it now.

I won't try to predict but will tell my experience - in case you have not read it in the forum.

My Mom stopped her chemo on 1/28, 1/30 scan revealed cancer still present & in some cases bigger. Instead of recovering without chemo, she got weaker & ended up in the hospital in late Feb, Hospice a week later & died 3 weeks later.

She had various little symtoms & issues they chased in the hospital but the source was the cancer. Her eating was not great during chemo & steadily went away completely.

One of the hemotologists / oncologists explained to me one night that the chemo certainly does bad things to good cells but it also controls bad stuff going in your body. But when chemo is stopped the good cells are slow to respond while infections, etc just take off - my Mom's white count jumped immediately.

Also the cancer in the digestive tract disrupted so many things for my Mom - whatever she did eat just backed up and became painful with the only way to relieve was to vomit. Then the constipation became an issue. I can go on & on. Needless to say, it was not pretty. Disclaimer - every patient experience is unique.

I will say that when she stopped eating completely - the discomfort went away but it was the beginning of the end. Her last week was peaceful if there is such a thing waiting to die.

Hospice is a big help but a major shift from battling symtoms to just making the person comfortable. They also provide counseling and support to all family members. It can be done in a hospital, special facility or at home.

Again, your MIL not eating & having pain are common signals of something going on.

You might want to speak to a hospice program on your own as they might offer you some support on how to work thru the family issues.

icedyaria · Regular Joined: 24 Oct 2008 Posts: 22

many thanks for your reply and advice,

just a quick update: MIL was able to eat some soup today and i believe she is in less pain. as she was admitted over the weekend, we have not yet had any updates from doctors.
my fiance seems somewhat more upbeat and is considering not going home for another week.
obviously, i know that every patient's case is different, but in general, what is there that can be done to make her able to eat again? and if there is nothing that can be done, does that mean that she will effectively starve to death?
i know i have been asking the same questions over and over again, but this is rather preying on my mind.
i appreciate all and any information that you can give me.
many thanks,

yaria

icedyaria · Regular Joined: 24 Oct 2008 Posts: 22

many thanks for your reply and advice,

just a quick update: MIL was able to eat some soup today and i believe she is in less pain. as she was admitted over the weekend, we have not yet had any updates from doctors.
my fiance seems somewhat more upbeat and is considering not going home for another week.
obviously, i know that every patient's case is different, but in general, what is there that can be done to make her able to eat again? and if there is nothing that can be done, does that mean that she will effectively starve to death?
i know i have been asking the same questions over and over again, but this is rather preying on my mind.
i appreciate all and any information that you can give me.
many thanks,

yaria

wannaknow · Senior User Joined: 19 Oct 2007 Posts: 118

icedyaria:
Appetite Stimulation - Yes, there's medication(s) that can stimulate a person's appetite - but there was limited benefit in my Mom's case.

The Pancreas is a complex organ that performs multiple tasks in the whole digestive process. When it began, we seemed to focus on insulin but that leaves out enzymes which help digest......and I'm sure there's much more I never uncovered & there has to be some link to the brain with regard to appetite.
My Mom took enzymes too.

Starving - Don't know if your MIL has a Living Will and what instructions she has laid out regarding extraordinary treatment ie; feeding tube, hydration or resuscitation. Certainly, there are high calorie liquid supplements & other ways to get the most out of a small appetite.
But I also found there was a human side to it where the patient just does not want to eat no matter what even though they know the consequences. Hard to understand but we are not in their shoes.

The location of her cancer (known & unknown) also plays a big part too - so do not factor that out. Not easy, I know.

icedyaria · Regular Joined: 24 Oct 2008 Posts: 22

i just spoke to my fiance and once again, my concern was discouraged. his family don't believe in doing anything so forward as urging a doctor to talk to them, let alone asking any questions and therefore, there is very little new information.
MIL was able to eat some pasta today. she says she has an appetite and would have liked to have eaten the whole plate but is unable to.
from a purely practical perspective, my fiance has a phd to finish within a set time frame and if this becomes a long, drawn-out affair, he will need an extension on his funding. should we expect this to last longer than a few weeks? goodness, i feel truly awful asking so bluntly, but since my concern is not appreciated and it would upset my future in-laws if i went to see her myself, i am currently trying to care only about my fiance in this matter. i feel bad about it, but i am not a care-giver in this case and those who are have chosen to purposefully remain ignorant.
i hope you don't think too badly of me.
best wishes,

yaria

wannaknow · Senior User Joined: 19 Oct 2007 Posts: 118

icedyaria:
I can't tell you how many times "things" did not go according to a plan, timetable, guess or even as predicted by even doctors, nurses, etc.

There are so many variables involved that it's almost impossible even when You know it would help the patient.

If there are things that really have to get done then getting others to "fill-in" while caregivers attend to that matter makes sense. Plus caregivers need more breaks than they ever take.

Just like the 'ol saying = a watched pot never boils - Trying to use a watch, clock or calendar can be very frustrating.

Help where you can & do your best there........the rest will take care of itself............and don't forget to take care of yourself.

TCUS · New User Joined: 18 Apr 2009 Posts: 1

Icedyaria-
My MIL also was diagnosed w pancreatic cancer in Sept. 08- Did the chemo and eventually stopped due to pain and not eating. Once she stopped eating, we admitted her to the hospital. They told us "she is dying" call hospice. We took her to hospice house (wonderful) and there she rested comfortably for 9 days. Amazing what the body can go through. She passed on April 25th. Very sorry for anyone who is going through this. This is a horrible cancer.

jessica28 · New User Joined: 31 May 2009 Posts: 3

my mom couldnt eat either..she wanted to but was in SUCh pain after she did,,she had her last 'meal' a week before she passed.
she ate only because we were guests in someones home and she felt it would be rude if she didnt eat..she suffered such pain that night..i cried my eyes out for her.
we got home and realized this was much more than any of us could handle anymore..she needed more care than we could give her and we didnt feel we were stopping her pain with a billions of pills we were then forcing down her throat at the time.
we took her to hospice the next day and she was angry..she yelled and cried and worried for her daughters and grand babies.

if you ask hospice they have a book on the "end of life process"
its helpful for anyone being a caregiver

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