Is the answer ‘it depends’? I"ve heard stories of people who have terminal cancer and are doing fine until the last few weeks or months. Is this common? Or is a more common outcome many months, or possibly years, of painful decline?
This is for terminal cancer, not cancer that can be cured or put into remission.
Well, it depends. Most “terminal cancer” is due to metastases, namely bits of cancer that moved from their point of origin to different parts of your body and decided to grow there. So it kind of depends on where they are growing as to whether they are seriously disrupting the functioning of the body or causing any symptoms at all.
Bone metastases are notoriously painful. Some mets block the colon or strangulate other organs. Mets in the brain can cause seizures and behavioral changes. Some secrete hormones and other bioactive substances that alter the entire body. A lot of mets are completely asymptomatic. Some spontaneously rupture and the patient rapidly bleeds to death.
Eventually, though, the number and size of metastases will increase to the point where the body simply can’t function anymore.
It depends on the type of cancer and age of the patient, of course, but most of the people who I personally knew declined slowly. All started out looking normal and healthy and over the course of 2-5 years lost more and more weight, and grew progressively more tired. At the end, they just slept more and more.
The two exceptions I personally knew were both women, both working moms. Both looked perfectly healthy and neither had a clue that they cancer* until it was far too late – too late to even attempt chemo because the cancer had advanced so far by the time it was discovered. Both were told to get their affairs in order, and both died within 2 months of being diagnosed. One had esophageal cancer IIRC, and the other had pancreatic cancer.
*One should have known because she had lost 25 pounds without trying, and had such a severe backache that she couldn’t lift her carry-on luggage.
What treatments they receive for cancer also have an effect.
When my dad was diagnosed he and my sister (who is an MD that specializes in end-of-life care) did some research and concluded that while various chemo and radiation treatments were either out of the question (due to age and level of organ function of liver and kidneys) or wouldn’t significantly extend his life but sure could make him horribly miserable he opted strictly for palliative care. He was lucky - neither the primary cancer nor any metastases were painful. His lung function became more and more impaired as time went on, but the physical decline was somewhat slow until the last month or so when his physical abilities really declined. The last couple weeks he was bedridden which was psychologically miserable, probably more so than the physical discomfort. He was just really, really weak.
Meanwhile, other people become bedridden for much longer periods, in some cases because the treatments that attempted to cure their cancer caused a lot of damage. It’s one thing if all that cures you and you go on to recover, it’s another if it doesn’t cure you and you have to deal with the side-effects as well as what cancer would have done to you anyway.
On the other hand, my father-in-law had two battles with bone cancer that resulted in remission for years at a time, with round three being the fatal one. In his case, aggressive treatment and surgeries were helpful in preventing paralysis, reducing pain, and preserving function for quite awhile. He was debilitated by severe pain, not only from the cancer itself but because of bone breaks that would never heal. In his case, the pain and inability to move had as much to done with his final decline as anything else. The levels of painkillers he required also weren’t helpful in that regard as they were sufficient to impair judgement, balance, and wakefulness, although certainly preferable to the alternative he would have faced. I mean, they helped a lot with the pain, which was good, but there were some side effects.
There is no disease called “cancer”.
There are 100’s of “cancers”.
Even within a specific organ - “Lung Cancer” or “Brain Cancer” there can be dozens of diseases.
Some “cancers” can kill quickly without needing to spread.
You may have seen recent “The Medical Establishment” has decided it was wrong to promote Prostate Cancer screening. Then it decided it should have promoted the screening, but only for certain groups.
IOW: Nobody Knows. Prostate cancers can be incredibly slow growing - hence the:
“Even if you have it, something else will kill you before the Prostate Cancer can get around to it”.
Both of my parents died of “Lung Cancer”. What he had was nothing like what she had. Which one is “how Lung Cancer works”? Both of them - and dozens of other profiles - are found under “Cancer of the Lungs”.
As a cancer grows, it may reach a catabolic state - it grows to the point that ordinary metabolic processes in the body are unable to fuel the extra burden imposed by the growing tumor, so the body starts breaking down or catabolizing larger molecules that are not normally consumed in a larger overall process called cachexia.
In other words, the cancer directs the body to start eating itself.
In my husband’s case, it was an almost overnight “flip a switch” change, and he went from seeming outwardly OK - well-nourished, mobile, lucid and conversational - to frail and weak, then to gone within a week.
This is what I’m wondering, will there just be an overnight change, then rapid deterioration.
It depends. Really. There are dozens and dozens of different ways to die from cancer.
My MIL just passed away from liver cancer. For her, there were few symptoms at first and she ignored the small ones that presented until it was basically too late to do much about it. At diagnosis, they gave her 6-12 months and she lasted for just under 7 months. During that time, the progression was absolutely heart-wrenching as she lost 1/2 her body weight (she barely ate anything, and what she did eat often came back up), slept for longer and longer periods of time and lost the strength to do just about anything without assistance. I am grateful that she’s no longer suffering.
Is the general rule that the cancer cells continue to spread into more and more body parts until the body can’t survive with that pathogen inside of it? And how long it takes depends on various factors including what organs develop tumors and where in the organs they are?
It depends … bodily functions start shutting down one after another … for my father, it took two years; for my mother, a month.
Yep, sorta? AIUI, certain cancers “like” to spread to certain organs. Colorectal cancer likes moving to the liver and the lungs. Breast cancer likes to go to the bones, brain, liver, and lungs. Etc. The reason for this isn’t much understood, but once the cancer cells hit the Lymph Node Highway, they’re almost impossible to fully eradicate. But as usedtobe said, even within cancers of the same body part, there are many many variations and subtypes.
Aha! Here’s an answer to your question! http://www.cancerresearchuk.org/about-cancer/cancers-in-general/cancer-questions/how-can-cancer-kill-you
You’re almost looking for a doctoral-level explanation here, but the best you’ll probably get here is anecdotal citations. A popular saying around here is that the plural of “anecdotes” is not “data” even if some of us with first-hand knowledge and an actual physician have offered their experiences and knowledge.
Some more brain-dump from me:
One notion that I ran across while researching my husband’s cancer (DLBCL-DH-GC, or diffuse large B-cell lymphoma with double hit germinal center, MYC and BCL-2 translocation) is that there’s no one “lymphoma” or “liver cancer” much less one “cancer” out there, and that it almost needs to be thought of as “gotpasswords’ husband’s cancer,” and “amaguri’s mother in law’s cancer,” etc. as the specific genetics, chemistry, environmental factors, concomitant diseases, etc. make it highly personalized. Great improvements have been made overall in how cancers are treated, but for the most part, we’re still working with some pretty blunt weapons.
The speed at which a tumor grows is different than the speed at which it may metastasize. Some tumors are slow-growing, aka indolent, and they may be content to stay in one place like most forms of skin cancer, and others are aggressive, malignant monsters that grow fast and spread fast. Leukemia and lymphoma tend to be in this category as they’re cancers of circulating fluids (blood or lymph) so they are circulated absolutely everywhere in the body, just waiting for a comfy spot to move into.
Some other things for you to look into are tumor grading, the TNM system and cell differentiation.
Yeah, it depends.
My two anecdotes:
My father appeared completely healthy. He woke up in the middle of the night vomiting up blood and went to the doctor the next morning. A few days later he was diagnosed with terminal esophageal cancer and was gone within 5 weeks.
My mother had some neck pain which after about 3 months was traced to a tumor pressing against her spinal column. Eventually traced to liver cancer that had begun to spread. She lived a normal physical life for another 2 months, then just collapsed at home one day. She then spent another 8 weeks on hospice care at home.
There really is no general rule. A lot of cancers block vital organs or functions as they spread, so the person can go from fairly functional to sick to dead very, very quickly. Block a lung segment, get a pneumonia in it as a result, die in a few days or weeks; block the bowel and cause it to rupture as a result, die in hours, erode into a major artery and die in minutes, grow in the brain to a critical size and cause the brain pressure to grow so great and the brain pushes itself out of the skull down the spinal canal and die in seconds, etc. etc. etc.
And that’s just a few macro effects. There’s probably as many different ways to die with cancer as there are ways to die that don’t involve cancer.