How do you know when the end is near for a cancer patient?

OrangePowder · 2021-05-29T13:20:47+00:00

And how near? He's past the timescale we were originally given and TBH until the last couple of weeks hasn't really seemed that ill. He's had a lot of pain, but seemed well in himself if that makes any sense. Over the last few days, he's really reduced what he's eating. Still has a reasonable breakfast, but nothing else all day and is refusing even sips of drink. He says it makes him fee sick. It takes ages to get him to take the tablets. Asleep a lot and mostly just whimpering when he's awake. I know this isn't the place to ask really, but his medical people seem to want to skirt around it. I know it's not good, but what might we be looking at?

MissGendered · 29/05/2021 14:27

I googled this a lot in my dad's last years.

I guess everyones different but my experience was its not a slow, steady decline to the end. Many times we thought he was slipping away, only for him to bounce back and have a good few months. He went though periods of not eating or drinking and also increased appetite.

In the end he went suddenly, ate fish and chips on the Friday then died sometime over the weekend (he refused full time care). His carer found him on Monday. She did say he seemed confused the last time she saw him.

So sorry you're going through this 💐

HollowTalk · 29/05/2021 14:35

Who is the patient, OP? If you are very close to them it's very tough if you're not given this information. I'm so sorry you're having to go through it.

Dinosauratemydaffodils · 29/05/2021 14:44

The last week or so my dad barely ate or drank. I kept taking fresh fruit/lemonade which disappeared but it turned out he was giving it to the nurses for their breaks. However I agree with a previous poster, he seemed to rally at the end. The night he died, he was really chatty when I took ds to see him that afternoon and then he phoned my mum for the football results at 8pm. Came as a total shock. We knew he was out of options and that it was just a matter of time but I really didn't expect it that night.

Sorry OP

Bargebill19 · 29/05/2021 14:45

Can you speak to his nurse - I’ve found they tend to be more open and honest. They tend to notice those little signs which indicate the time is close.
💐

Original poster

OrangePowder · 29/05/2021 14:45

I think it's quite well known that patients can rally in the last 24 hours?

It's DH. A nurse from the Hospice is on her way

OP posts:

Grizalda · 29/05/2021 14:51

I'm sorry you're going through this op

NoSquirrels · 29/05/2021 14:52

I’m so sorry you’re going through this.

I think when how rapidly a decline happens is a good guide. If someone’s condition is deteriorating over months, they’ve got months to live. If it’s noticeable week by week, then weeks. If it’s declining day by day, only days.

My mum seemed well and eating properly until maybe 3 days before she died. Then the decline happened quickly. No matter what and if you expect it, it’s still shocking and somewhat unreal.

Sending you love The hospice nurse will be wonderful, they are so knowledgeable.

honkytonkheroe · 29/05/2021 14:52

My dad was sedated at the end but he went from being how you describe to dying 10 days later. If he hadn't been sedated he would have been in huge amounts of pain. My mum rapidly deteriorated and died about 4 days later but she did have pneumonia. On the whole though, my experience is from friends and relatives, is that it can go on much longer than you think. I'm very sorry you are having to deal with this. I hope you've got support.

lljkk · 29/05/2021 14:53

It's unpredictable, often a roller coaster.

It can depend on the type of cancer. People with more aggressive cancers go quicker, basically. You may know a lot about this type of cancer (not just bone or colon, but what stage, specific variant, etc)

My Fit healthy vigorous mid 30-something friend went from "I have a mystery lump" to bedridden in 8m & her demise 5m later. Older people go more slowly than younger people all other things considered, too.

NoSquirrels · 29/05/2021 14:55

It does sound like his pain needs more management than the tablets, from your description. Getting him comfortable should be everyone’s goal. He’s no need to feel pain at this point, they can sort that.

Bagelsandbrie · 29/05/2021 14:57

So sorry you’re going through this.

My mum (died aged 70 from bowel cancer) had a couple of very good days in her last week and then suddenly went downhill. She said she felt like she suddenly had very bad flu (that’s how she explained how she felt) and stopped eating / drinking. The last day she was a bit restless in the morning and kept fidgeting around like she couldn’t get comfortable in the bed and then by the evening she wasn’t really with us anymore.

I hope the hospice are able to help. If he seems in pain make sure they sort you out with a syringe driver now rather than wait - the pharmacies etc caused delays with my mums which meant she went longer without one than she should have.

Original poster

OrangePowder · 29/05/2021 15:16

I hope the hospice are able to help. If he seems in pain make sure they sort you out with a syringe driver now rather than wait - the pharmacies etc caused delays with my mums which meant she went longer without one than she should have.

Thank you, that's helpful. I hadn't thought about what happens when he can't take the tablets. It's obvious now, but it hadn't occurred to me.

OP posts:

Twothirtyam · 29/05/2021 15:22

I asked every this question constantly when going through this recently with a parent and never got a straight answer. I guess because they honestly just couldn’t say as everyone is different. In the end it was definitely a longer process than I had expected and then had been the case when my other parent had died of cancer some years before. I think about three weeks from stopping eating completely (just drinking water) to actually going. Seeing someone I love deteriorate so slowly is the hardest thing I’ve ever experienced so I’m sending all my sympathy to you. The only thing I take comfort from is to know that they were surrounded by love every step of the way. I hope you’re doing ok.

Wilma55 · 29/05/2021 15:23

My mum had hospice nurses in but they couldn't or wouldn't say how long even when my brother asked should he cancel going away at the weekend. She died the next day.

starrynight21 · 29/05/2021 15:29

They really can't tell you a time frame. It's not that they are skirting around it - they just don't know. People can remain in one stage for a long time, or just pass away quickly. If your DH is still eating and taking his tablets he is probably not in the last stages yet.

I'd agree with PP that he needs a syringe driver if he is in pain . Make sure to get that sorted out, he'll need it more and more as time goes on.

Shedbuilder · 29/05/2021 15:29

In my experience it's very difficult to predict. My mum was given a maximum of six months and lived for more than three years, but every couple of months had an event (a blockage, an infection, need for a transfusion or other treatment) that left us sure 'this was it.' Her GP (lovely man) said she was a medical miracle.

The month before she died was like many previous events she'd survived. She slept a lot more, didn't want to eat, just took small sips of fluid and food a few times a day. Most days the GP or district nurse would call round to check on her and every day they'd say that they thought the end was very close. She went on and on. The last two or three days her breathing became shallower and she wasn't awake or alert at all. Her breathing did change in the last 12 hours and that was our sign that the end was near.

Thinking of you. Caring for someone dying is very hard.

Original poster

OrangePowder · 29/05/2021 15:45

It's really hard. I'm still trying to work. If I knew it was a matter of weeks or even months I'd take some time off, but I can't take years off. I'm going to have to support myself and DC after he's gone, I need to hang onto the job somehow.

OP posts:

Bagelsandbrie · 29/05/2021 15:45

@OrangePowder

I hope the hospice are able to help. If he seems in pain make sure they sort you out with a syringe driver now rather than wait - the pharmacies etc caused delays with my mums which meant she went longer without one than she should have.

Thank you, that's helpful. I hadn't thought about what happens when he can't take the tablets. It's obvious now, but it hadn't occurred to me.

Mabelene · 29/05/2021 15:51

My MIL died a few months ago. She had an unusual type of cancer but when I googled it, it said that from stopping eating it would be about 8 weeks, in the event it was about 6 weeks

Sending you strength

schofieldsunderpants · 29/05/2021 15:57

So sorry you're going through this Orange

KatherineJaneway · 29/05/2021 15:58

Sorry you are going through this

Now, on reflection, I can see my Mum was going downhill but it is sometimes so hard to see as you don't want it to happen and you are so close day to day you don't see the deterioration.

Lack of appetite, weight loss, sleeping a huge amount, not wanting to engage. It is awful.

2bazookas · 29/05/2021 16:00

@OrangePowder

I hope the hospice are able to help. If he seems in pain make sure they sort you out with a syringe driver now rather than wait - the pharmacies etc caused delays with my mums which meant she went longer without one than she should have.

Thank you, that's helpful. I hadn't thought about what happens when he can't take the tablets. It's obvious now, but it hadn't occurred to me.

If swallowing is hard they will give him a syringe driver, (fixed needle with a little reservoir) and show you how to top up pain relief as needed with a finger push. If his pain is not well controlled, ask for one.

Get the hospice nurse on her own out of DH earshot and ask the  direct questions you need to.  Also, ask what other support the hospice can offer you as his carer.

Marie Curie's cancercare website is here

and they have a support phoneline 0800 090 239

stayathomegardener · 29/05/2021 16:01

Could you afford to take two weeks off now to spend some slightly better quality time together and recharge yourself?
Even if it's months it would be time well spent now. You may also get compassionate leave right at the end too.

PippyPinky · 29/05/2021 16:09

With my mother, it was a couple weeks from when she stopped eating to the end. The hospice nurse wouldn’t give estimates until three days before her death, when she told me it wouldn’t be long now. She woke and spoke a few times after that but was fairly hazy. It’s a very tough time. I wish you the best.

NoSquirrels · 29/05/2021 17:15

@OrangePowder

It's really hard. I'm still trying to work. If I knew it was a matter of weeks or even months I'd take some time off, but I can't take years off. I'm going to have to support myself and DC after he's gone, I need to hang onto the job somehow.

I would ask for some leave right now. It’s better to take the time now, and extend it if need be, than to struggle on feeling you are not doing right by anyone.

If he rallies with pain relief sorted out, then great - you spend some relaxed days together, make a plan for going back to work. If he’s no better or worse, discuss with the hospice nurse what to do.

Either way some time off now will take the pressure off you. Your work will be understanding.