I realized most of the images people have when you say dead from cancer seem to relate more to the modern treatments of chemo and radiation, not just the emaciation and the hair loss but symptoms too like vomiting etc.
Before these treatments what did most cancer patients look like? If someone was asked to imagine a cancer death what would they have thought of?
In many cases, emaciation will occur even without the debilitating effects of chemo or radiation. http://en.wikipedia.org/wiki/Cachexia
My maternal grandfather died about 25 years ago from stage 4 pancreatic cancer. There was no treatment available, as it was too advanced for surgery. He turned very jaundiced, lost a ton of weight (very dramatic as he was a weightlifter into his late 60’s until he became ill) to the point of being skeletal, became bedridden as he had no energy to move, and died in his sleep from liver failure 3 months after diagnosis.
My mother was diagnosed with stage 4 pancreatic cancer 9 months ago (not a candidate for surgery), and has been on agressive chemo. She’s lost her hair and a bunch of weight, but other than that is still going strong. She gets tired more easily, but still goes out and does things. Now, she is responding unusually well to the chemo, and could easily last another year or more, and her quality of life is pretty good, all things considered.
As an aside, I hope when I get diagnosed with stage 4 pancreatic cancer (seriously, seems to run in the family) in about 30 years, they will have a real cure.
Not all cancer patients even now receive chemo. My grandad didn’t, because he was so old that the chemo would likely have just worsened what time he had left (it was his choice, on the advice of the doctors). He had prostate cancer for about four years, much longer than expected, and essentially looked like a healthy old man.
Other cancers have more obvious effects - a lot cause weight loss, and obviously sometimes tumours are visible. But many of the other people in the hospice were in a similar position to my grandad and just looked a bit off-colour.
If nothing else, couldn’t they treat it more effectively if it’s diagnosed at an earlier stage? Given that you have a family history, you should probably be getting enough tests to catch it early.
Even for people with a family history of pancreatic cancer, screening for it is very controversial.
■The yield of screening has not been uniformly high. A five-year prospective screening study of annual screening with EUS and MRI in 76 asymptomatic high-risk individuals found only one intraductal papillary mucinous neoplasm (IPMN).
■While both Pancreatic intraepithelial neoplasia and IPMNs clearly act as precursor lesions to invasive pancreatic cancer, whether early identification and treatment will improve outcomes is uncertain, given that only a small fraction of progress to invasive cancer. There is no test available to determine malignant potential.
■No study has ever shown that screening improves survival.
From: UpToDate.com, a subscription medical website.
Plenty of people die not knowing there was anything wrong with him - a friend of my dad’s went into the hospital for shoulder surgery, contracted pneumonia in the hospital which seemed at the time to partly be from poor medical care so they did an autopsy… guy was eaten up with lung cancer. Never knew it. Looked just like a guy who dies from pneumonia.
Yes, If diagnosed early, they cut it out (sometimes taking out the whole pancreas). If it works, its the only cure. Once its metastasized, you can’t cure it. Unfortunately, pancreatic cancer doesn’t cause symptoms until its advanced; when they catch it early, its because they were looking for something else.
No real tests other than scanning, which they usually don’t do routinely because of the radiation issues. Ultrasound can be used in some cases, but its not nearly as good. I actually had a CT scan 2 years ago for something unrelated, so I know I’m in the clear right now.
I suspect cancer deaths were often far more gruesome in pre-oncology days., and even more so before curative or palliative cancer surgery was feasible.
You would have had markedly advanced local cancers eating away normal tissue, as well as deaths from sepsis and/or organ failure secondary to tumors occluding biliary drainage, the urinary and gastrointestinal tracts (much more controllable now due to stenting, radiation and bypass surgery).
And that doesn’t even take into account uncontrollable pain prior to introduction of effective painkilling regimens.
Even with current limits on medical and surgical therapy for cancer, outcomes were a lot more unpleasant in the “good old days”.
My grandfather died of stomach cancer. He was well into his 90s at the time, so no real treatment was given. This was back in the 1960s. As long as I knew him he was paunchy. By the time he died he was very thin. My father’s sister took care of him, and I recall they used to give him creme de menthe to drink. I was a teenager at the time.
My mother-in-law died about 5 years ago from colon cancer. She was also untreated because of her advanced age (also in her 90s). Her symptoms were anemia and resulting weakness. She died in her own home, in her sleep, of a heart attack brought on by the above. I don’t think she was in any particular pain.
It would depend on what type of cancer it was and where it was growing. For example, an acute leukemia can go from essentially unknown to full blown in a matter of days. It can knock out someone’s immune system, they get septic, and die of shock. A cancer that can grow unnoticed and spread widely, such as pancreatic or stomach, might make one emmaciated and weak, dwindle away. One that causes a local problem, such as a lung cancer obstructing an airway, might cause pneumonia and the person dies of that, after experiencing increasing shortness of breath for a while. In contrast chemo tends to hit people in much more similar ways, as stated in the OP. So in sum, I’d say that before chemo, etc, cancer deaths were more heterogenous, as a whole.
Does that last point only refer to pancreatic cancers? I’m reading the book The Emperor of All Maladies: A Biography of Cancer, and it stated multiple times that screening has been effective for at least some cancers.
wasn’t there a thing where someone would turn into a walking cancer and be displayed in freak shows?
All those points refer only to exocrine pancreatic cancer. Many other cancers do have effective screening methods which can identify them early and improve outcomes (no sense in identifying them earlier if it doesn’t make things better). But many others also do not.
My husband’s mother was diagnosed with a rapidly growing small cell cancer of the lung just before she died. No signs of it on an x-ray done 3 months earlier, and then suddenly it was huge. Because it was pressing on her lung and diaphragm, it made her short of breath, and she got a pretty bad pneumonia. The cause of death was officially cardiac arrest, however, because she decided to have them turn off her internal cardiac defibrillator so she’d die quickly.
Were it 100 years ago, it would have looked like any other “died in her sleep” while fighting pneumonia.
Really hard to do with pancreatic cancer, that’s why it’s so deadly.
My husband began feeling nauseated and exhausted all the time and went to the doc. He had an endoscopy and blood tests that came back clean - and they were specifically looking for cancer.
3 months later the tests were repeated and they found pancreatic cancer, it had already spread to the point of being inoperable.
All the accounts I’ve read of Caesar Rodney show that his cancer caused a painful decline similar to that seen today.
I’m trying to think of other sources. Cancer was certainly known in Shakespeare’s time. Bardolph has a large tumor on his nose. SPOILER FOR HENRY THE FIFTH
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Unfortunately for us, Bardolph’s theivery gets him hanged before he can die of cancer.
While there aren’t any photos of John Adams’s daughter’s bout with cancer, someone posted a link a while back that had a contemporary account of her losing battle with breast cancer. A rather gruesome read.