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Stage IV cancer. Unknown primary with extensive peritoneal implanting. Should we get TPN?

Posts: 3
Joined: Oct 2012

Hi everyone.
I'm new to this forum. My friend was diagnosed with stage 4 cancer in July. They think the primary may be gastric according the the cell block they got from taking cells from her ascites fluid. Her ascites subsided, but she now has a very palpable stomach mass and a malignant bowel obstruction. They think surgery is way to risky. They wanted to send her home on hospice. We went to another hospital and they were about to send her home with TPN and chemo, but after talking with her original oncologist they convinced her family to put her on hospice. Since then, I've been the main one taking care of her (at least all of her medical needs - she is on IV hydration with potassium and has a PEG tube for venting only). It's been two months now and she is very weak as she has not had and nutrition. They don't recommend TPN as her tumor was very aggressive. But she is so weak now and sleeping most of the time. I really want her to get TPN or at least a blood transfusion because her low RBC count. She is handling her fluids well and aside from losing a lot of weight seems to be fine. She has no pain which is a blessing. I've done lots of research on TPN for palliative care. Statistically it doesn't increase survival and often has complications. But I'm hoping that it might improve her energy and quality of life during this time. Does anyone have any experiences with palliative TPN or blood transfusions?

Thank you all for your help!

Posts: 100
Joined: Jun 2012

Hi David...
Your friend has been through it and it's a very difficult situation. First of all, welcome here though I wish we could not have if you know what I mean. I'd be very interested to know what TPN is. I was thinking that I might know this by another name. My thoughts are with you and your friend.

dorothymarion's picture
Posts: 28
Joined: Apr 2012

Hello Patsie,

Feeding a patient intravenously with a nutritional supplement when they are unable to digest food in the normal way is known as TPN, or total parenteral nutrition.

David, my thoughts and prayers go out to you and your friend. All of us here are either battling our own particular cancer or have a loved one that is going through this fight.


Posts: 100
Joined: Jun 2012

Thanks for the information. The decision to use TPN or not is probably a complex one. The only thing I would say is that my sister's father-in-law, who also has cancer, has drinks which he uses to replace meals he can't finish and ones he misses altogether. He went to see a dietician recently who removed the drinks from his prescription list and very quickly, he became tired and had a major nosebleed which put him back in hospital and on an IV drip for fluids and IV antibiotics. He also needed a transfusion. I was just wondering what your friend feels about having TNP?

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