Update and seeking advice for Mother in Law
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Bob….Like you I wish for others chime in and share their thoughts with us. Moderators are here to help guide, but our input it not intended to replace that of the experts i.e. those that can share first-hand experience.
Hugs,
MarionThank you Lainy and Marion for your quick and perceptive replies. Yes, the issue we’re struggling with, my wife and I, is how to balance being non-intrusive and nonjudgmental while at the same time helping someone we love get the best, most informative perspective on a very difficult decision. Your replies are so helpful – it is of course not up to me to decide, and my wife and I are aware that our approaches to what is a terminal illness won’t be the same as hers. Still, no one wants unnecessary suffering, least of all for someone we love so much.
So….its very helpful to hear from the patient’s and caregivers’ perspective. Our Oncologist is great – while absolutely willing to provide whatever treatment my Mother in Law wants, she also wants to frame this decision in the most medically realistic, helpful and informative way possible.I guess one additional question we want to ask this board is how elderly people in general tolerate Xeloda/ Capcitobine. Is it milder than gemcitabine? Similar in side-effect profile? I realize patients respond differently, but its been tough watching how much the Gemcitabine has wiped her out, leaving her with hardly any energy at all most days. Its seems to take a week or more to recover from a short trip away from the house. Do patients in the experience of people on this board get somewhat better energy after stopping a given chemo protocol? Does the quality of life often improve for a period of time?
Thanks Again,
BobBob…..at this time, other than a curative resection, palliative treatment encompasses every treatment for this cancer. It’s likely that your in laws feel better and stronger because – like many others – they are doing something to fight off this cancer. By the same token, they are willing , as you mentioned, to “suffer” through the side effects. Who can argue with that? It’s a personal decision and it is that to make by your mother in law. However; is it her wish or is it that of her husband of 50 plus years? Cancer patients have a tendency to not want to upset their families by “staying” alive at all cost; they can’t bear the thought of hurting their loved ones. Perhaps it is possible for a family member, a physician, clergy (if applicable) or a person very close to her and have a heart to heart talk with your mother in law.
Hugs,
MarionDear Bob, the age old question of to chemo or not. When my Teddy at the age of 78, reached this point his ONC offered him Palliative Chemo which means to make one comfortable but still has chemo side effects. Teddy asked him, “if I was your father what would you advise me to do?” The ONC said it becomes a choice of quality time over quantity. The quantity would be adding maybe a month to life. Teddy chose quality. He felt he had been through enough and for what? Too buy one more month? It is a very personal decision although most of our members seem to choose quality. Perhaps the family can have a ‘meeting’ to discuss all aspects but know that MIL also needs to be heard. As I mentioned in another post just yesterday, sometimes the patients need some gentle guidance.
Wishing your family the very best and I am sure other members will chime in.Hello,
I originally posted back in March to this remarkable site to hear from others with more experience treating CC. My now 80 year-old mother in law was diagnosed in February of 2015 with likely CC (true origin unknown). CT at that time found 2 tumors on her liver, one 3 cm and one 5 cm. Cancer stage 4 and biopsy showed high grade, poorly differentiated cells. No spread of disease detected outside of the liver.
She started treatment with Gemcitabine and Abraxane, and then quickly switched to Gem/Cis , which she initially did fairly well on; tumors shrank after a few months. However, Gem/Cis was too the side effects were too rough, quality of life not good, and for the past 5 months or so her team has maintained her on only Gemcitabine, dropping the cisplatin . The main side-effect has been fatigue, lack of appetite, some weight loss, with bouts of neutropenia, a few hospitalizations with pneumonia (x3). Tumors are located peripherally, so no jaundice, etc. Liver enzymes within reason, hematocrit around 27 and stable, white count back up to normal between infusions.Now after 7 months of on Gemcitabine, the tumors have returned. Our oncologist thinks Gem no longer effective. She is consulting with both Mayo clinic and Dana Farber to get additional opinions as to what to do next. Xeloda (capecitabine) seems like the best option to our onc. . That, or discontinue chemo in favor of better quality of life. Some discussion of “targeted therapies” as a possible option.
Our Oncologist wonders if continued chemotherapy is the best option at this point, since quality of life is the primary goal, from the beginning of treatment until now. My mother in law and her husband of more than 50 years think that maybe if she can suffer through a bit longer on chemo the cancer will finally be cured and this whole difficult trial will be over. She has been told that treatment is palliative, by her medical team and by her kids, but this is a very difficult thing to comprehend and really understand.
This is just my best quick sketch of this case. Any ideas would be very helpful, and let me know if there is anything important I’ve left out that would help us get better advice from this collective source of knowledge.
Yours,
Bob
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