chemo brain in parent with terminal cancer

[tharsheblows]

The setup: my dad is 74 and was diagnosed with Stage 4 lung cancer in March after a couple of months of not being able to get rid of pneumonia. He's terminal and has had palliative radiotherapy because the cancer that had metastacised to his bones was causing a great deal of pain and now is having chemo with the idea that it will also help with the pain and give him a bit longer and more importantly better time to live. He's had 5 of 6 chemo treatments as of today.

I live in the UK and he's in the US, so I haven't seen him for nearly three weeks but have been out there more often than not since the beginning of March and am going back on Saturday. When I left, he was slightly foggy-minded and a little confused but from what I understand from my mother, he's gone hugely downhill and is a quite bit loopy and sleeping constantly.

I've been reading up a bit about chemo brain / delirium and dementia but was wondering if anyone had any thoughts or experiences or just a "YOU NEED TO KNOW THIS" idea about it. (One of the best things I learned from MN was the fact that my son would vomit blood after a tonsil- and adenoidectomy. It helped me not panic when it started...)

My parents tend to under-react rather than overreact and are the type to not want to bother the doctor, etc etc.

Thanks!

Have they talked to his oncologist about this? If not, then they really need to discuss it very soon

Hi, I have breast cancer that spread to my bones a number of years ago now. You might want to check out the symptoms of hypercalcaemia (sp?) it causes most of those symptoms and requires prompt treatment.
Best Wishes.

My first thought was that the cancer could have spread to his brain, when did he last have a scan? I agree with pp that he needs to talk to his oncologist, or you need to, to establish just what is happening. I am sorry you are going through this.

Thanks - I really appreciate all the advice. I, stupidly and unfortunately, don't have his nurse's phone number or I'd call. (I need to make copies of all of those for myself when I'm here and he's there - should've thought of that before I needed it!) He's having chemo today though, so, fingers crossed, my mother will talk to the nurse about it. Actually, they had the blood test appointment and meeting with the senior nurse (she is good) yesterday, so it should have come up then.

He had a ct scan about 4 weeks ago, although not sure they did his brain. His last scan that included his brain was in March or April right before radiation started and there was no cancer then. The last scan (the one 4 weeks ago) showed that the tumours on the bone had diminished (ie the ones they targetted with radiation), the ones on his lungs were a bit smaller and on his adrenal glands were the same (which is not larger, therefore good).

For various reasons, I am not completely sure how out of it he is - it's really difficult to get a straight and coherent answer from my mother sometimes. So I'm not sure how much I should worry. I suppose I'll find out this weekend if I got it right.

My mum had lung cancer which spread to her brain. She started to become quiet and a bit muddled in her talking (nb. She wasn't muddled in her head, just her words were, she knew what she wanted to say). The symptoms depend which part if the brain is suffering I think.

Anyway although they scan, they don't always scan the brain for some reason.

I suggest a brain scan if they can organise one. I'm not trying to scare you, but if we'd known sooner we might have been able to do something.

Thank you all again - I think it was / is hypercalcaemia, here's what my mom emailed - well, the relevant bit... :

"Returned from today's scheduled chemo appointment which did not happen. More lab tests were taken and we spent 3 hours getting lots of fluids for dehydration"

From what I understand, this would be the treatment. He easily might have gotten other drugs along with the fluids, she isn't terribly precise or accurate sometimes. Anyway, I'll actually speak to her today and try to find out a bit more. It's been very hard on her, so I won't push. And I'll be there this weekend and then for the next 6 weeks. I can speak to the doctor and nurses myself if we have questions - I am generally the one do that when I'm there.

Again, thank you so much. I really appreciate the information! :)

Oh and his next scan is after his last chemo, so in a couple of months. If his confusion doesn't clear up after this has been treated, I will talk to them about doing a scan sooner. I think he was properly loopy rather than just a little muddled though.

Thars, there are definite dips in their well being and the impact of these is massive, even on a day to day basis.

My Mum, too, slept a lot. When she was in the hospice - the consultant oncologist explained that it was like past, present, future all break down. I would add reality to that. My Mum had a few incidents prior to this stage but seemed to rally.

I hope they get your Dad out of pain.

My dad was like this last year. It started about two months or so before he died. He would dip in and out of strange conversations with people who weren't there, or else he was busy fighting in old war battles (he was too young to have fought in the war), or he would see strange things eg cats, or the enemy under the bed etc. He didn't have brain cancer, but I think it was either his body just shutting down, or side effects of all the medications he was taking for his cancer, morphine etc. Very, very sad to see.

Thanks, it's really good to read other experiences, even if they're not terribly reassuring. I'm in the US now and he seems ok-ish but definitely has regressed from just over 3 weeks ago... to the point where I've asked his brother and sister if they'd like to come visit him because I'm not really sure he's going to get much better anytime soon. (His brother and sister will stay with me - I live next door-ish and like them both.)

He goes back to the doctor on Wednesday for a follow up and more fluids (? this is coming through my mom) - I'll find out what they say for myself then.

Again, I really appreciate the info. Everyone in real life seems to have an opinion of what we should do, what could be causing it, etc etc. I'm so sick of people.