Question:
My sister died only 3 months after being diagnosed with stage IV cancer. It
was found in her lungs and brain; however, radiation had shrunk the tumours
and lesions, and she regained use of her hands. She seemed to be improving.
She then got pneumonia in the hospital, and when that was cleared up, she
got flluid in her lungs that they said was from the cancer. Yet the cancer
in her lungs, I was told, was the size of a pea. Her complications included
diabetes and previous heart trouble (ten years ago she had congestive heart
failure and was on medication for that). She was on a lot of pills for these
things and had been living a full and active life. She suddenly lost use of
her hands and legs, the cancers were diagnosed, radiation and pills made her
better. Then she died suddenly because of fluid in her lungs building up and
I was told she refused to be intubated even though she had had her lungs
drained several times. She had a do not resuscitate order, but in my
discussion with her when she wrote the document, that applied to only if two
doctors agreed her condition was fatal. She did not want to be kept alive in
a coma by artificial means. She wasn't in a coma though. It made no sense to
me that she would refuse the draining of the lungs after having it several
times. Earlier in the day she had shown no signs of confusion or worsening
of any symptoms. In no way did she want to die. I also was told her blood
sugar was over 500. Yet she was being given insulin injections. Previously
she handled her diabetes with pills and diet. They told me the radiation
treatment interfered with her diabetes. When I asked about these things her
children became hostile. They didn't want an autopsy. For me it is a mystery
why she could die in just 3 months, and die suddenly in such a way. Is this
normal for stage iv cancer?. I was told she died of a heart attack or heart
failure, as her heart gave out when she could not breathe. They only gave
her oxygen because of her refusal of the intubation. To me it seems
unbelievable they would not intubate her since she accepted it before. It
was not on her list of "do not do".
Have any of you heard of this type of cancer causing fluid buildup in the
lungs; of someone dying this way? It doesn't look like it was the cancer, it
looks like a misunderstanding of the meaning of her "do not resusitate"
orders. I live far away and her daughter was in charge of her care, but I am
just concerned about the scenario as it was told to me.
Answer:
I think sometimes one specialist or another gives out a prognosis based on
the type (and stage) of cancer and there's 4 types of lung cancer. And others
may give out prognoses based on their patients experidnce with same type/stage
of cancer without considering co-morbities and others may give the maximum time
the person has and others may give the "median" (which i explained earlier) or
others may state a prognosis, based on many patients who had brain mets and
lived longer with radiation therapy.
For instance, Bob's here and he had a brain met and had RT and I think he's
celebrated his 3rd year.
See, it can vary? The doctors can't win, when giving a prognosis. If they give
one too dire and the patient lives longer, the patient (or loved one) may feel
they're out of the woods too soon and in your sister's situation, it worked the
other way, a longer prognosis, that just wasn't to be.
I have mom's autopsy here and she had widespread bone mets in her spine and the
tumor was only affecting one lung. There was extensive spread to her mediastinum
and numerous large mediastinal lymph nodes. There were several nodular mets, in
the liver ; the largest measuring approminately 4 cms, in the right lobe. When
I first read that, years ago, I was angry. It sounded (to me) that it should
have been curable, if only they'd caught it earlier, but the knowledge i've
gained, on the internet, since, tells it was not to be, once in the liver and
the number of mets. It took a long time to come to terms. What I'm saying is
while it sounded minimal, I realize, now that her cancer burden was a lot more
extensive than I realized at the time.
I don't know when this happened with your sister, but if it helps you, stay with
us. I'm here to listen and care, if you think talking more about it, will help
you come to terms.
