Stage IV cancer. Unknown primary (possibly gastric) with extensive peritoneal implanting. Should we

itsdavid Member Posts: 3
Hi everyone.
I'm new to this forum. My friend was diagnosed with stage 4 gastric cancer in July. They think (but they're not sure)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!


  • have2believe
    have2believe Member Posts: 134
    hard to say
    My mom has gotten blood transfusions but I learned that it's always very risky. As far as TPN, it's been a Godsend for my friend's mom who has no appetite and is getting chemo. I think the main point is to re-examine the goal. If she is near the end, it might be important to just focus on comfort care. But if she wants to receive pallative care and get tpn, ask the dr if it's make her feel more energized. I'm guessing her fatigue is due to lack of nutrition and also the disease itself.

    You should also contact the Can't Stomach Cancer foundation. They might have some info on this.