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Suggestions regarding treatment?

Sassie
Posts: 4
Joined: Sep 2006

Hi everyone. My mom has been very sick for the last year. The doctors thought she had COPD... but it turns out she has small cell lung cancer. It has spread to her brain and her liver. They are giving her 6 mos to a year, and to be honest... she doesn't look good at all. She can barely walk, she doesn't eat hardly anything, and she sleeps all day long. They started her on dexamethasone for appetite, and radiation for her brain tumors, but my dad and I can barely get her to go for the treatment, she says she is just too tired. She can't even take a shower or walk by herself. She's so weak, she's 72... and now they want to start chemo. I am a nurse myself, but cancer was not my speciality. I hate to say this but I am afraid she can't handle the chemo. My dad doesn't want her to do it, but she wants to try it. Of course we will always respect and support her decision. But she is so very weak. The doctors rush us in and out, like doctors do, and of course they have lots of treatments, but they aren't explaining much to spite me and my assertiveness... believe me I ask questions if they like it or not.

So I came here, because I know often time people who have lived something know it better than anyone. What is the chemo really like? Can someone that weak really handle it? Have any of you found a medication that really helps with appetite that you could suggest? Are there any suggestions that you can give me on helping her prepare for chemo if she decides to try it.

I appreciate any suggestions you can give. And I am so glad to have read some of your stories. They are such stories of hope.

kaitek
Posts: 156
Joined: Aug 2006

Hi Sassie,

I'm sorry to hear about your mom's diagnosis of small cell lung cancer. But don't let that discourage you. It can be beaten as you can read on this site - no matter how advanced the cancer is.

My mother has stage 4 NSCLC. Initially, she could barely walk as well because of breathing difficulties. She lost her appetite early on, but forced herself to eat. And I can completely understand about your mom feeling too tired. All of those conditions and symptoms were what my own mom went through. She is 76.

The cancer is debilitating and causing this physical degradation. But once the treatment can diminish the cancer cells, your mom may regain her previous physical vigor. It is key that the oncologist tailors the treatment that will work for her. So, ask for genetic tests or even chemosensitive testing. If a biopsy was done, then they should have samples of the cancer cells for those tests. These tests aren't absolute. You may be able to increase the effectiveness of treatments with a good diet - particularly cruciferous vegetables (unlike a few people coming onto this site, I'm not selling anything). The most recent news I read on cruciferous vegetables has shown insight on the mechanisms of how these vegetables inhibit or destroy cancerous cells. The isothiocynates compounds turn off the bcl-2 protein in cancer cells that allow those cells to be resistant to chemo. With those protective cells shut down, apoptosis can go to work on cancer cells.

I had fears about how my mom's comfort with chemo. I read about the side effects. The oncologist went over each of them with us. Certainly some of them sound scary. BUT, I can attest that my mother's comfort hasn't been compromised at all. She doesn't even have nausea, though she takes an anti-nausea as a precaution for 3 days following chemo. My mother's oncologist said that at my mother's age of 76, she is young of the patients he's put on chemo. He has patients in their 80s. So don't let your mom's age hold you back. On her weakness, I tend to believe it is symptomatic of the cancer. Reduce the cancer and she should feel better noticeably. But it is very important she gets her nutrition, preferably from foods.

Other than encouraging your mother to go for chemo, my suggestions to help her get through it is to care for her as much as possible: feeding, bathing, helping her walk to the car (get a wheelchair) to get to her appointments. As the chemo works its magic, she may begin to gain enough strength - and even her appetite - to much of the rest on her own.

With her appetite suppressed, you may want to experiment with foods that she finds palatable. Have her eat small meals like every 3 hours instead of big, full meals just 3 times a day. You may want to puree foods to make it easier for her to swallow.

Good luck to you and your mother. Feel free to email me should you have any concerns. I'm not an expert but I can give you my perspective of getting through this emotionally intact and helping my mom battle her cancer. Don't hesitate to get chemo for your mom. Just be sure you have a competent oncologist.

Sassie
Posts: 4
Joined: Sep 2006

Thank you so much for answering my question. I want you to know that I called my dad on the phone, he does not have a computer, and I read your email to him. It was very encouraging, and my dad said maybe it is best to let her try the chemo, he had just heard such terrible things about it. I think honestly he was giving up completly on hope. She finishes her radiation in one week, and they plan to start the chemo. Hopefully, it will goes as well as it did for your mom. Thank you again for your encouragement.

kaitek
Posts: 156
Joined: Aug 2006

It's my pleasure Sassie. You made my day that your dad became more convinced and confident about chemo. Your mother needs all the encouragement she can get. I would shelter her from negativity so she can focus on healing.

I've been learning that radiation can really put a patient through the ringer. So, don't be too discouraged because your mom came out of radiation almost wasted. If she's anything like my mom, she will take the chemo with little discomfort. When the oncologist prescribes the anti-nausea pills, be sure your mom does take the pill at least nightly at bedtime to prevent any nausea. They say that you don't want to wait until that feeling comes up when it may be difficult to alleviate. You want to preempt it with the anti-nausea pills. So even though my mom has never experienced nausea, I have her take a pill (it's actually the cheap one) at bedtime.

I am a believer that diet can enhance chemo. I recently read the positive news about cruciferous vegetables promoting cancer cell death from shutting down the protein that helps the cell be resistant to chemo. So, if I were to give you one dietary advice, I would implore for your dad to serve your mom a variation of the cruciferous vegetable family every day, particularly the days around chemo to boost the chemo's effects.

Again, you're free to email me anytime for your concerns or if you need advice. I promise you I'll spare you of any snake oil pitches. I won't endorse anything that I don't give my mom. If you've kept up with my messages, I primarily stick with food as the source of nutrients.

Good luck on the chemo. Best wishes to you and your family.

Plymouthean's picture
Plymouthean
Posts: 264
Joined: Jan 2004

I believe that you are not getting the help from your Mom's doctors that she needs and deserves. Your assertiveness notwithstanding, they should be doing what it takes to explain things to you, your Mom and your Dad. I would definitely seek another doctor for another opinion. And don't listen to "how long she has". My doctors never mentioned prognosis, - they concentrated on what they had to do to fight my "incurable/inoperable" cancer. When you accept poor a prognosis, you give up. If your Mom wants to try chemo, that tells me that she's not ready to give up. I think that she deserves all the support you can give her.
Chemotherapy side effects are different for every patient. I had very aggressive chemo. It made me very fatigued and weak. I simply listened to my body and rested/slept much of the time. Chemo can, and often will, cause nausea. My nausea was controlled with medications. I would suggest instant breakfast drinks as a nutritional source. They are more palatable than Ensure, and those others. Also, if she can eat solids, try serving many small meals, instead of three large meals. The mere sight of a large plate of food will discourage or overwhelm a patient.
My prayers and best wishes to your Mom and your family. Please keep us posted.

kaitek
Posts: 156
Joined: Aug 2006

Hi Sassie again,

I should have stressed (as Plymouthean did) that everyone does experience chemo differently. But hopefully your mom's oncologist can adjust the dosage of the chemo so your mom can tolerate it. If you need a reference point of how much my mom receives, I can doublecheck.

Be aware that chemo has an accumulative effect. It took many weeks before my mom's hair began to fall out. And it took longer for a little numbness in her fingertips and toes. My mother isn't bothered by the numbness as the sensation is very slight. If and when her blood count is low, don't get stressed or worried about that. It's part of the chemo's destroying cells without distinguishing healthy cells from cancerous ones. The doctor will administer shots to boost her count up.

My aunt had a good perspective on the chemo. She felt that if there weren't side effects, the chemo wasn't strong enough. It should be a balance of enough to knock out those cancer cells too.

Sorry about repeating that suggestion about cruciferous veggies. I didn't read my previous message and forgot that I had already shared that news. Seriously, I don't hold stocks on any farms growing cruciferous veggies.

I do have another suggestion to care for your mother. You said that she can't shower by herself. You may want to get her a child's plastic stool for her to sit on in the bathtub. That will make it easier for her and whoever may bathe her. And if your parents have fixed showerheads, I would highly recommend the handheld showerheads.

On days when she just doesn't want to go into the bathtub, you may get the bath wipes. For in-between baths, that could be a good solution.

Again, I hope your mother responds well to chemo.

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