Hi everyone.
I'm new to the cancer forums. My friend (age 22) was diagnosed with stage 4 cancer in July. They think the primary may be gastric according the the cell block they got from taking cells from her ascites fluid. Her ascites subsided, but she now has a very palpable stomach mass and a malignant bowel obstruction. They think surgery is way to risky. She did one round of chemo right before the obstruction. They wanted to send her home on hospice. We went to another hospital and they were about to send her home with TPN and chemo (they gave her some TPN while in ICU and a light dose of chemo), but after talking with her original oncologist they convinced her family to put her on hospice. Since then, I've been the main one taking care of her (at least all of her medical needs - she is on IV hydration with potassium and has a PEG tube for venting only). It's been two months now and she is very weak as she has not had and nutrition. They don't recommend TPN as her tumor was very aggressive. But she is so weak now and sleeping most of the time. I really want her to get TPN or at least a blood transfusion because her low RBC count. She is handling her fluids well and aside from losing a lot of weight seems to be fine. She has no pain which is a blessing. I've done lots of research on TPN for palliative care. Statistically it doesn't increase survival and often has complications. But I'm hoping that it might improve her energy and quality of life during this time. Does anyone have any experiences with palliative TPN or blood transfusions? Also, when is it too late to try chemo? She's lost so much weight and can't walk without help anymore.

Thank you all for your help!