Hello,
What a great discussion board this is. I wish I had found it a month ago.
My name is Mike and my 85 year old mother was diagnosed with NSCLC stageIV on
March 9the 2006. At that time she had a 6.7 cm tumor in her right lung with 6 mets to the brain with the largest being 19mm, one 15mm and the other four about 10mm. She also had a tumor on her L-5 vertebrae that was causing a great deal of pain. She lived in a small town in Arkansas and I immediately brought her to Dallas so that I could take care of her. I am an only child and there is no one else to help, just my wife and I.
The doctors here did the biopsy and found NSCLC adenocarcinoma. An MRI of her head showed the brain mets and a bone scan showed the spine tumor to be pinching a nerve and also showed it to have caused a fracture in L-5. She also had a met to L-1 and three mets to her ribs.
She underwent 12 whole brain radiation treatments and 2 and ½ radiation treatments to her spine. The radiation oncologist stopped the treatments because she became so weak. She was to start Tarceva last week, but her attending physician (the medical oncologist) said she was too weak to start it. Since that time she has become much weaker. She cannot get out of bed without help and lifting by me, my wife, or the nursing aid that comes in 3 days a week to help us. She sleeps at least 18 to 20 hours a day and her appetite has steadily decreased even though she is taking Megastrol (sp) to help her appetite. Her urination frequency has decreased to about once in every 10 to 12 hours (from every 4 or 5 hours last week). We will take her to the doctor on Wednesday for a chest X-Ray and for a decision on the Tarceva.
Before she started radiation she was in great spirits. While she was in the hospital for the biopsy the doctors did a vertaplasty on her L-5 that greatly reduced her pain. She became weaker every day she had radiation treatment, and has gone downhill every since. Since she is only receiving palliative care, our big concern is whether or not the Tarceva will make her quality of life worse than it is, and it cannot get much worse. I know the Tarceva causes some side effects, but fewer and milder that any other chemo treatment. Any input about this would be welcome.
She has exhibited many of the signs of the pre-active stage of dying over the past week. I don't know if I should insist on hospice care yet, or continue with the home nursing we are getting now. She has home visit from an RN every week now, with a nursing aid to bathe her three days per week. By God's grace she is not in a great deal of pain. She is losing weight very fast ( only eating about 300 to 400 calories per day). Should I ask for hospice now, or wait? The oncologist had told me a month ago that she would have 6 months to 1 year is both the radiation and the Tarceva worked, but only 2 months if it did not. Since she is 85 years old, the doctors tell me she probably will not regain her strength. If she cannot get better, I don't want to make her worse.
Mike