Cancer end of life question

My wife has advanced Stage 4 adenocarcinoma of gastric origin. She has large
mets to the Ovaries/omentum and diaphragm. She was diagnosed Jan 2007. She
has failed three different courses of chemo agents. No surgery. In the last
three weeks the following has occurred:
1. Severe malignent ascites (confirmed via cytology of paracentesis)
2. Alk Phos elevating to near 100
3. CA125 very high level.
4. More nausea, vomiting and loss of apetite.
5. More lethargic

My question...though we have been devastated by this and I am still hopeful
for a miracle, based on the above signs how much time do we have left? I need
to start preparing I think for her subsequent needs and wishes...

Thanks

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"Deck via MedKB.com" wrote:

> My wife has advanced Stage 4 adenocarcinoma of gastric origin. She has large
> mets to the Ovaries/omentum and diaphragm. She was diagnosed Jan 2007. She
> has failed three different courses of chemo agents. No surgery. In the last
> three weeks the following has occurred:
> 1. Severe malignent ascites (confirmed via cytology of paracentesis)
> 2. Alk Phos elevating to near 100
> 3. CA125 very high level.
> 4. More nausea, vomiting and loss of apetite.
> 5. More lethargic
>
> My question...though we have been devastated by this and I am still hopeful
> for a miracle, based on the above signs how much time do we have left? I need
> to start preparing I think for her subsequent needs and wishes...
>
> Thanks

Hello Deck,
Hang in there for a reply from Steph, or maybe Ian (Bozz).
I have some numbers about othere patients here, but I'm having server problems.
Tomoorow maybe.
Reminder for Steph - his wife has Gastric outlet obstruction
J

"Deck via MedKB.com" <u31227@uwe> wrote in message news:7b35a585a74ac@uwe...
> My wife has advanced Stage 4 adenocarcinoma of gastric origin. She has
> large
> mets to the Ovaries/omentum and diaphragm. She was diagnosed Jan 2007. She
> has failed three different courses of chemo agents. No surgery. In the
> last
> three weeks the following has occurred:
> 1. Severe malignent ascites (confirmed via cytology of paracentesis)
> 2. Alk Phos elevating to near 100
> 3. CA125 very high level.
> 4. More nausea, vomiting and loss of apetite.
> 5. More lethargic
>
> My question...though we have been devastated by this and I am still
> hopeful
> for a miracle, based on the above signs how much time do we have left? I
> need
> to start preparing I think for her subsequent needs and wishes...
>
> Thanks
>
> --
> Message posted via http://www.medkb.com
>

Wouldn't you be much better asking her oncologists?

But if this patient was described to me by a colleague over the phone, I
would say days to a few weeks in all probability

Thank you...I have spoken to our oncologist about this and he was fairly non
specific stating that it could be weeks or many months. On the good side is
that she was started on a "rescue" chemo for the ascites with CPT-11 just a
few days ago, I may be reading too much into this, but she seems to be doing
MUCH better in just that last 48 hours. Is that possible? Appreciate the
input.

Deck


Steph wrote:
>> My wife has advanced Stage 4 adenocarcinoma of gastric origin. She has
>> large
>[quoted text clipped - 15 lines]
>>
>> Thanks
>
>Wouldn't you be much better asking her oncologists?
>
>But if this patient was described to me by a colleague over the phone, I
>would say days to a few weeks in all probability

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Thank you...I have spoken to our oncologist about this and he was fairly non
specific stating that it could be weeks or many months. On the good side is
that she was started on a "rescue" chemo for the ascites with CPT-11 just a
few days ago, I may be reading too much into this, but she seems to be doing
MUCH better in just that last 48 hours. Is that possible? Appreciate the
input.

Deck

J wrote:
>> My wife has advanced Stage 4 adenocarcinoma of gastric origin. She has large
>> mets to the Ovaries/omentum and diaphragm. She was diagnosed Jan 2007. She
>[quoted text clipped - 11 lines]
>>
>> Thanks
>
>Hello Deck,
>Hang in there for a reply from Steph, or maybe Ian (Bozz).
>I have some numbers about othere patients here, but I'm having server problems.
>Tomoorow maybe.
>Reminder for Steph - his wife has Gastric outlet obstruction
>J

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Message posted via http://www.medkb.com

"Deck via MedKB.com" <u31227@uwe> wrote in message news:7b3bc9befd950@uwe...
> Thank you...I have spoken to our oncologist about this and he was fairly
> non
> specific stating that it could be weeks or many months. On the good side
> is
> that she was started on a "rescue" chemo for the ascites with CPT-11 just
> a
> few days ago, I may be reading too much into this, but she seems to be
> doing
> MUCH better in just that last 48 hours. Is that possible? Appreciate the
> input.
>
> Deck
>


If she's doing much better, she's doing much better...........so of course
it's possible.

"Deck via MedKB.com" wrote:

> Thank you...I have spoken to our oncologist about this and he was fairly non
> specific stating that it could be weeks or many months. On the good side is
> that she was started on a "rescue" chemo for the ascites with CPT-11 just a
> few days ago, I may be reading too much into this, but she seems to be doing
> MUCH better in just that last 48 hours. Is that possible? Appreciate the
> input.
>
> Deck

Hello Deck,
Bozz's wife had GOO as well, but had a G-tube for feeding.
I cannot recall where her mets were.
He spent considerable time mashing the food to feed into the tube.
She was diagnosed Jan/06 and passed away Mar 25/07 = 14 months?
Her ascites appeared in October/06.
As best I can recall chemo was continued for quite a while.

What wishes were you thinking about ?
If it's visiting places or people, isn't it better getting it done, while she's well
enough?
Also I think hospice can be called in if the oncologist says she has 6 months or
less so go by what the oncologist thinks. And check what's available in your area,
when you have time. Don't leave until last minute, please.

Best wishes with the treatment.
Keep in touch, please.
J

Thanks J and Steph,

Yes, Hospice setup, friends visiting and making sure her wishes are carried
out. I will have a more detailed discussion regarding Hospice this week with
the Oncologist...

Best to you both,

Deck

Steph wrote:
>> Thank you...I have spoken to our oncologist about this and he was fairly
>> non
>[quoted text clipped - 8 lines]
>>
>> Deck
>
>If she's doing much better, she's doing much better...........so of course
>it's possible.

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On Nov 15, 9:15 am, "Deck via MedKB.com" <u31227@uwe> wrote:
> Thanks J and Steph,
>
> Yes, Hospice setup, friends visiting and making sure her wishes are carried
> out. I will have a more detailed discussion regarding Hospice this week with
> the Oncologist...
>
> Best to you both,
>
> Deck
>
> Steph wrote:
> >> Thank you...I have spoken to our oncologist about this and he was fairly
> >> non
> >[quoted text clipped - 8 lines]
>
> >> Deck
>
> >If she's doing much better, she's doing much better...........so of course
> >it's possible.
>
> --
> Message posted via MedKB.comhttp://www.medkb.com/Uwe/Forums.aspx/cancer-board/200711/1

my luck and best wishes to her, and your family!I
http://www.spymac.com/details/?2295305

"Deck via MedKB.com" wrote:

> Thanks J and Steph,
>
> Yes, Hospice setup, friends visiting and making sure her wishes are carried
> out. I will have a more detailed discussion regarding Hospice this week with
> the Oncologist...

Please let us know how it's going, Deck.
I'll be here, as often as possible.
J

J wrote:
>> Thanks J and Steph,
>>
>> Yes, Hospice setup, friends visiting and making sure her wishes are carried
>> out. I will have a more detailed discussion regarding Hospice this week with
>> the Oncologist...
>
>Please let us know how it's going, Deck.
>I'll be here, as often as possible.
>J
Thanks J.

Well, this weekend was bad, On Friday she had severe nausea/vomiting/diarrhea.
Her white count on admission was 0.7 (she is on CPT-11). The hospital is
trying to keep on top of her nausea and pain, but it seems with only limited
success (they have even tried tincture of Opium). She remains very lethargic..
..I will talk to the oncologist today about home hospice...your thought are
appreciated.

Thanks,

Deck

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Message posted via MedKB.com
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"Deck via MedKB.com" wrote:

> Well, this weekend was bad, On Friday she had severe nausea/vomiting/diarrhea.
> Her white count on admission was 0.7 (she is on CPT-11). The hospital is
> trying to keep on top of her nausea and pain, but it seems with only limited
> success (they have even tried tincture of Opium). She remains very lethargic..
> .I will talk to the oncologist today about home hospice...your thought are
> appreciated.

Hello Deck,
Well, I'm not an expert, but she's sounding much worse than I expected (just) 7
days after the CPT-11.
It says here http://www.chemocare.com/bio/cpt.asp that the diarrhea is supposed to
peak around 11 days.
And the tincture of Opium is supposed to help with that but nausea (and other) can
be a side effect.

Oh, I just checked a few places and, I think, they're both alkaloids, maybe that's
the problem.
Good thing to get hospice involved, Deck. I hope they'll get things improved for
your wife.
They're the experts.
We'll be here as you able.
J

J wrote:
>> Well, this weekend was bad, On Friday she had severe nausea/vomiting/diarrhea.
>> Her white count on admission was 0.7 (she is on CPT-11). The hospital is
>> trying to keep on top of her nausea and pain, but it seems with only limited
>> success (they have even tried tincture of Opium). She remains very lethargic..
>> .I will talk to the oncologist today about home hospice...your thought are
>> appreciated.
>
>Hello Deck,
>Well, I'm not an expert, but she's sounding much worse than I expected (just) 7
>days after the CPT-11.
>It says here http://www.chemocare.com/bio/cpt.asp that the diarrhea is supposed to
>peak around 11 days.
>And the tincture of Opium is supposed to help with that but nausea (and other) can
>be a side effect.
>
>Oh, I just checked a few places and, I think, they're both alkaloids, maybe that's
>the problem.
>Good thing to get hospice involved, Deck. I hope they'll get things improved for
>your wife.
>They're the experts.
>We'll be here as you able.
>J


Thank you. She is doing better for now. Her white count is increasing and her
nausea/vomiting is much better, still with some minor diarrhea. Still has
abdominal pain. The good news is that she is coming home today! Onc wants to
start the CPT-11 back up next week as long as her counts are good. will keep
you posted.

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"Deck via MedKB.com" wrote:

> J wrote:
> >> Well, this weekend was bad, On Friday she had severe nausea/vomiting/diarrhea.
> >> Her white count on admission was 0.7 (she is on CPT-11). The hospital is
> >> trying to keep on top of her nausea and pain, but it seems with only limited
> >> success (they have even tried tincture of Opium). She remains very lethargic..
> >> .I will talk to the oncologist today about home hospice...your thought are
> >> appreciated.
>
> >Good thing to get hospice involved, Deck. I hope they'll get things improved for
> >your wife.
> >They're the experts.
> >We'll be here as you able.
> >J
>
> Thank you. She is doing better for now. Her white count is increasing and her
> nausea/vomiting is much better, still with some minor diarrhea. Still has
> abdominal pain. The good news is that she is coming home today! Onc wants to
> start the CPT-11 back up next week as long as her counts are good. will keep
> you posted.

Watching for your update, Deck.
Best,
J

Thanks J,

Well, her counts are back up thanks to neuprogen. She is back on the CPT-11
and her ascities is stable and apparently being kept in check by it. The side
effects of this drug are brutal compared to all the others we have been on,
esp the diarrhea and muscle pain. My continuing concern is her severe
lethargy and the pleural effusion which was worse on the last chest xray
(looks like only the superior 1/3 of both lobes are clear and visible) so as
you can imagine she is also quite short of breath with minor effort. Will
keep you posted.

Deck

J wrote:
>> >> Well, this weekend was bad, On Friday she had severe nausea/vomiting/diarrhea.
>> >> Her white count on admission was 0.7 (she is on CPT-11). The hospital is
>[quoted text clipped - 14 lines]
>> start the CPT-11 back up next week as long as her counts are good. will keep
>> you posted.
>
>Watching for your update, Deck.
>Best,
>J

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