Stage 4 pancreatic cancer life expectancy 92 year old, do I cancel my surgery?

[Chikoroll]

Sorry, this is long.
Mum is 92 and lives alone. She has carers three times a week.
She fell last week and was taken to hospital.
Outcome is stage 4 pancreatic cancer with a collection of fluid in her lungs presumed to be a malignant pleural effusion.
Mum refused “the big needle” biopsy and just wanted to go home.
She has been complaining of lethargy and weakness recently and has told me her weight has dropped from 80 kg to 65 kg in the last 2 years.
She is very tired and after showering ( with assistance and on a chair) she was too tired to do anything else. (Slept for 2 hours in her chair)
Her dietary portions are minute, we scrambled an egg with some tomato and she ate half of it. 1/3 cup of porridge for breakfast type portions.
Doctors say anywhere between 3-6 months.
My problem is I live 9 hours away and I have major surgery booked for 24/6/24. If I go ahead with this surgery, I won’t be able to travel for 4-6 weeks.
My gut feeling is to postpone the surgery, take long service leave and go to stay with her.
My hesitation is if she does get to 6 months, I will be living with my current condition for a lot longer.
i am seeking people’s experience in this situation and how long they think Mum will still be here?
many thanks for any input

Thank you everyone for sharing your experience and the kind thoughts and messages

My family member was diagnosed in the December of one year and died the following June. Another family member was diagnosed this Janaury with stage 4 but is having chemotherapy to try and prolong their time which seems to be helping.

You never really know but I think given your mums age Id postpone the surgery. Im so sorry, its heartbreaking.

My dad died in his nursing home. My mother had thoughtful familiar surroundings and so on but it was a mistake. They were set up for dementia but not palliative care. I did in the end demand morphine and for them to stop messing about with oral drops when his swallow mechanism was gone. He would have done much better in hospice care.

10 weeks from diagnosis here but your mum seems further along as appetite has already reduced. Not an exact science though predicting. Keep strong for her but get support in real life for you, it's a tough end - hugs

Losing my mum was the single most miserable time of my life to date . She also had cancer, but not of the pancreas.

My sincere condolences Op, it’s a very tough time for you all. Hope your dear mum has good care during this 💐.

Two weeks

Do you have a Hospuce at Home Service where your DM is? We're in the UK and the local Hospice sent someone to sit with DF in the night until a Hospice bed became available. It was a Godsend and meant that we could get some sleep.

many hospices allow you to stay with them and the pain relief will ensure you get quality time with her.

ICU nurse in the national pancreatic specialist hospital, previous gastro nurse. I would agree that 3-6 months is incredibly optimistic for stage 4 panc cancer in an already frail 92 year old. I think your mother is wise to refuse further invasive diagnostic interventions. I would delay your surgery if your health allows, however you matter as well and only delay if it means your condition doesn’t deteriorate.

i would start getting things in place now, Marie curie nurses, community palliative care team, anticipatory care medicine prescriptions etc. up the carers to as much as possible, 4 times a day is possible. I’m in Scotland so not sure how it works if your in England but district nurses can supply equipment such as hospital beds to be in the living room as she most likely won’t be able to get up stairs soon, even if you have a stair lift. Commodes etc. stand pushing now don’t wait until symptoms progress as unfortunately the wheels move slowly and you don’t want to be in a situation where your mother is suffering and things just aren’t moving quickly enough. It is possible to have a peaceful death but it takes a lot of support so don’t be afraid to shout for it. 💐

Lost my DDad to this in 2021
Age 96 1/2
He was 12 days from diagnosis to death. His had spread to his liver rather than his lungs.

I felt with him he accepted the "game was up" after he was diagnosed and he accepted his fate and didn't fight it but it was frighteningly quick. No pain thank goodness but he got obviously weaker every day. I read somewhere afterwards that the rate of decline is a good indicator of lifespan. Daily decline is days to live
Weekly decline is weeks etc
The tiredness was a massive thing I noticed, he was always downstairs dressed and shaved by 0830 (no carers needed) with great energy for someone of that age until the last few weeks when this noticeable huge tiredness/exhaustion set in.

I'd postpone your operation, explain the diagnosis to them. PC is often quick and they should know that
I wish you all the best for what lies ahead

Definitely cancel, she's going to need someone there all the time really......the most important thing is to keep on top of her pain management as pancreatic cancer can be an extremely brutal death. I lost my mum to it.

Mum is very aware time is short, but is saying 3-6 months to people, as that is what she heard the doctor say.
She did, however, ask me to have my DD’s visit sooner rather than later. (Both planning on flying over with me this weekend).
In Australia it works a bit differently and palliative care team pretty much only involved in the last 2 weeks of life. They do admit to the service earlier but really only come in at the end.
Palliative care first appointment is Thursday and one of the family will be with her for that. Hopefully we will have more information after that.
Carers are hard to come by and I have never heard of someone having a carer visit more than twice a day. Any more than that and nursing home placement is required.

I am so sorry so many of you have had this experience but grateful to you all as well

If I were your 96 year old mum, no way on earth would I want you to cancel your major surgery.
Sorry for the situation you find yourself in 💐

I get why you want to cancel the surgery.

But you’re not saying what that surgery is or what is the consequence of postponing it. I’d think carefully around that tbh.

Yes being with your mum is important.
But so is your health and possible impact fir years to come.

Obviously, if postponing means let’s say 6 months in pain you can cope with and no further issues from postponing, then yes I get your position.

Ahh very sorry to hear this. As pp have said at stage 4 there's often not a great deal of time.
Spend the time with her that you can but do look after yourself too

Get in touch with GP as well - talk about palliative care and end of life care and get her on those pathways. This means regular Visits by District nurses in England and Wales (not sure about Scotland) but also proper pain care which is critical with pancreatic cancer (they literally stick a box under the bed with the relevant drugs and equipment for setting up a driver for e.g. ) Eating will be difficult and as she approaches the end will tail of completely as the body slows and can't process it so I wouldn't force it, sips of water etc will also become difficult. One of the best tips we had was use pineapple juice and qtips to clean the mouth and keep it healthy. With my MIL she was very very private (not far off the same age certainly the same generation) and we managed baths with a very light nighty to cover her main body and she was happy with that but yes v difficult

Ahh OK Aus. Pain management is still really important and the old saying about the squeaky wheel ie gets more attention is true so squeak away

Im so sorry about your mum. That type of cancer isn't curable. My father in law died after 6 months peacefully.
My gran also had fluid in her lungs and I should warn you, this was awful. She refused treatment. Dr said one lung was filled and the other one more than half way....its basically like drowning. She was moved to end of life care in hopsital and they put her on morphine and increased the dose until she died. I would definitely look into your options for your mother if she is refusing treatment as she might not realise how awful it is when fluid increases.

At that age 3-6 months is optimistic so you made the right decision

Just to jump on the bandwagon of 'yeah, you probably need to cancel', my own experience (friends and my brother, though ironically, he didn't die from his pancreatic cancer- he was going to eventually but... that's for another thread) combined with your mum's information leads me to believe she'll be gone by August. I'm sorry to sound so awful and blunt, OP. And I'm so sorry that you've been dealt such a shock card. You're in for a tough summer. Courage and love to you.

They thought they’d caught it in time with my dad - diagnosed mid October 2014 with the Whipple procedure carried out 2 days after diagnosis. Didn’t think he’d need any follow up treatment. By January it had spread to his lungs and he died 1st Feb 2015. Very quick. It’s a truly horrible disease.

My Mum died of pancreatic cancer. At stage 4 she was told she had 3-6 months. She only had 5 weeks and 3 days. Once the appetite goes it's not long. In your position I'd go and stay with your Mum. Be there with her at the end if you can. I think 3 months is optimistic.

I am so sorry you and your Mum are going through this. My Mum died less than a month after diagnosis. She was in her mid-eighties.

So sorry. My grandma lived about 2 months. She was a similar age to your mum.