Yeah, that clear PET scan six months ago scares the crap out of me. To go from clear to stage 4 in six months? How does that happen with no symptoms?
IME, and again I am *not *a medical anybody … the no symptoms part is threefold:
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The body has awesome compensatory capability. Up to a point. And once that point is passed symptoms proliferate rapidly.
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Cancer growth is more or less exponential. 1 becomes 2 becomes 4 becomes 8 … becomes 1 million becomes 2 million becomes 4 million becomes 8 million. So by the time symptoms are unequivocal you’ve got a big problem that’s got a big head start and is now growing real fast.
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Folks, and especially older folks, tend to ignore slow-growing symptoms. Or tend to assume they’re temporary, then become used to them so they quickly become the new normal. An elderly person is well aware that mortality is out there waiting. Pretending not to hear the little scary noises in the night is a common reaction.
Good luck. Work for peace and for quality, not quantity, of life. If possible speak explicitly about this tradeoff with both MIL & the medical staff.
If you have not done so, read this book: http://www.amazon.com/Being-Mortal-Medicine-What-Matters/dp/0805095152/ You will cry. A bunch. But you’ll be better able to help yourself and your family for having read it.
I’m so sorry you guys have to go through this.
Best of luck. I hope she can go and enjoy that cruise.
She probably wasn’t telling him everything either.
I just did a quick google and found that there is some evidence that this may be true. From the National Cancer Institue:
I’m sorry your family is going through this. Hugs to all.
I can’t answer that specifically, but in the case of my mother, she went from a clear xray to both lungs fully involved in less than 18 months. Her case was the topic of the weekly hospital staff meeting. They pulled out all the medical info from her previous stay to see if there was anything that had shown up that they might have missed. They said that while they couldn’t positively rule out the presence of cancer cells, but if there were any, they were too few and far between to show up on the xray.
Update: We celebrated an early Thanksgiving on Sunday because my daughter was heading off to Army boot camp on Monday (yesterday).
We found out IvySIL has been bathing Mum because she’s shaky on her feet and falls. She had her first chemo last Monday and was not feeling well afterward.
She looked very frail on Thanksgiving, but she did eat a bit. The other IvySIL took a bunch of family pictures, then broke down on the patio (away from everyone else) because she realized it may be the last set of family pictures she gets.
Ivylad noticed she’s getting very bony. I just don’t think she has the energy to fight it. IvySIL says she’s not in pain. Mum did go over the will with Ivylad and his sisters (basically they already got their inheritance in the form of gifts, and anything that’s left will be divvied up between the grandkids.)
It’s a waiting game now. I think everyone knows this is it, unless the chemo performs a miracle and kicks the cancer out of the park.
Sorry to hear that, ivylass. More prayer on the way.
Regards,
Shodan
I was hoping for a more positive update. There is still hope though. Take care of yourself, and Ivylad.
Agreed this is a poor sign. Take care of yourself and everyone as best you can. Hugs.
Ivylad spent a few days over at his mother’s house and went with her to the doctor.
She’s down to 94 pounds.
She’s sleeping 18-20 hours a day.
But what is most concerning is when she was talking to Older IvySIL about her doctor visit, and talked about how the doctor is impressed with her progress and told her she’s a strong fighter.
On the contrary. The doctor wants a CT of her lungs and for her to talk to the radiologist. Progress and strength never came up.
She keeps saying she wants to fight this, but she’s not doing anything to fight it. I don’t know if she thinks she is, or if her body is shutting down and she’s not physically capable of forcing herself to move and eat.
Ivylad, I think, knows this doesn’t look good, probably because he doesn’t see her on a daily basis (the IvySILs live much closer). I don’t think his sisters have reached that conclusion yet. I’m afraid someone is going to come home one day from work or school and find her gone.
Thanks for checking in.
That’s not good news. Sorry to hear this. Is she in pain? Is she on a lot of meds?
More prayer for you and the family.
Regards,
Shodan
I don’t know what meds she’s on, but she says she doesn’t feel good. She’s always had a high tolerance for pain, and I know there’s medicine doctors can prescribe that can counter the side effects of chemo, but she says they’re not working.
IvySIL gives her those Ensure drinks and yesterday she ate a slice of pizza. But if you’re sleeping 18-20 hours a day, you’re only eating a little bit, since your body isn’t using the fuel.
Sorry to hear this, Ivylass. Thinking of you this holiday season.
The sleeping 18-20 is a dire sign. See Performance status - Wikipedia for a measure of how the docs look at that. That plus not eating is pretty strong indication the cancer is eating her alive from the inside out. All her metabolic energy is going into tumor growth.
If she’s receiving chemo at this point, you’re in a situation where for whatever reasons, good or bad, folks seem to be concentrating on extending her days, not improving her quality of remaining life. This is even more true if she’s suffering either pain or other common chemo side effects such as nausea or confusion.
It sounds to me like she is past the point where hospice would be better for her. Obviously people’s religious / moral standings get involved here too. But if that idea isn’t completely taboo to her or her immediate family, it’s a couple months past time to have that conversation. But even talking or doing something like that late is better than never. IMO, YMMV.
As a separate matter, statistics show a lull in deaths immediately before Christmas, followed by a spike to catch up. Folks in dire straits often set “survive until X” goals for themselves and some of those folks are able to stretch enough to reach them.
Good luck and good vibes to all your family as they work through this ghastly process.
Update:
Yikes.
Ivylad called me at work all happy. His mother had called to say that today at the appointment the doctor gave her a big hug and said she was cancer free!
She got home and called all of her friends and told them she was cured.
IvyMIL has had some issues understanding and remembering (could be chemo brain, could be her age and lack of activity) and at an earlier appointment imagined an entire conversation with the doctor that didn’t happen. So I was cautiously optimistic but not hopeful, considering how advanced the cancer is.
Sure enough, Ivylad’s older sister, who went with her to the appointment, said that the doctor never hugged her and never said she was cured. He did say the cancer had shrunk, which was a good sign, and they would continue chemo.
IvyMIL is understandably upset. She thought she was cured, then to find out that 1) she’s not and 2) she’s misremembering conversations is very frightening.
So, we continue the chemo and see how things go. She’s down to 92 pounds.
I’m sorry about this, ivylass. When my sister had lung cancer, she called me more than once telling me she was cancer free. She was all excited, bubbly, and happy. I’m pretty sure the doctor never used those words. She was always back on chemo within a couple months, so a slight remission was what she had each time. It was hard to see the ups and downs. I don’t know if she misunderstood or if it was wishful thinking. I don’t think it was chemo brain because she was fine with everything else.
I’m so sorry about your mother-in-law. I lost my Dad and Grandfather to lung cancer, within days of each other. Good luck and good thoughts to her, you, and your family.
Oh no. Poor thing. Cancer is awful enough, but for her to feel like her mind is now letting her down must be even more frightening.
I’m just glad your SIL was along at the visit. Definitely something that needs to continue, otherwise MIL could get into trouble just from failing to understand instructions.
On the plus side, tumor shrinkage is a good thing indeed.
She’s not driving anymore, so she will have someone with her at all doctor’s appointments.
I’ve looked into getting her some home care during the day, when everyone is out. Ivylad doesn’t think she’ll go for it, but I wanted to explore the option.
It’s been a while since I’ve posted an update, so if anyone is still interested, I’ll share.
Mum is no longer answering the phone. Ivylad has tried to call her several times over the past three weeks to no avail, and finally got ahold of our BIL. IvyBIL told us about Mum spending most of her time in bed, except when she gets up to smoke (that’s a whole 'nuther rant, which I will address in a bit) and at one point they discovered the phone unplugged. In order to talk to Mum, we will have to call the house and someone there will hand the phone to her.
She’s not eating unless someone puts food in front of her.
She had her last chemo yesterday, and she gained two pounds, getting her up to 87 pounds. 
She has low potassium, despite taking pills (again, someone in the house is making sure she’s taking them) and is getting a blood transfusion today.
She still thinks she’s going on the cruise at the end of the month. Given her state, I think that’s highly unlikely unless she suddenly starts eating like a horse.
So, I think we’re still playing the waiting game. We haven’t seen her since Christmas, and I’m going to suggest to Ivylad we visit her (if she’s up to it) this weekend.
Now for the Rant
MUM DOESN’T DRIVE, which means someone in the house went to the store and bought her cigarettes. :mad::smack: IvySIL says getting up to go out to the patio to smoke is the only thing that’s making her move, so I guess technically, this counts as “exercise,” but the cancer was shrinking on the one hand and you pile on with the coffin nails with the other? I know, I know, it’s probably a lost cause at this point, but for Christ’s sake.
Ivylad is frustrated, because he has his own health issues but tries every day to accomplish something. He doesn’t want to come across as a bully to his mom, especially if she has little time left. But he doesn’t understand her claiming that she’s going to fight it and not actually fighting it. (I think someone mentioned upthread she may not have the physical capability to fight it, despite her claims, which is probably likely.)
But it’s a vicious cycle…you don’t eat, so you have no energy to do anything, so you lay in bed and aren’t hungry, so you don’t eat…
God, what a mess.