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Chris B

Symptoms of remission

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Hi! :)

I don't have lung cancer myself, but my uncle has stage 4. And I've joined this forum, because I have a question.

He was sent home into home hospice care last New Year's Eve, just after having turned 80. He went home, barely able to breathe anymore, constantly on oxygen, and in a wheel chair, because he also had had a stroke. Even just sitting down he could not be without oxygen supply for 10mins without his blood oxygen levels dropping severely. He was constantly coughing up mucus and blood. 

Now, though, 2.5 months later, he is walking again, has no more oxygen supply at day time (even though he is moving!), sometimes loses it at night without noticing, and he doesn't need the mucus extractor anymore when he lies down. Because he is on hospice care, his insurance won't pay for doctors visits anymore. It's hard to imagine. :) But I'm from Germany, and my aunt says that that's how it is in the States.

So ... my question to the forum is: is it possible to still have stage IV, if you are ok without oxygen supply? If suddenly the lungs don't produce mucus as before anymore? Because to me it feels like this is very possibly a spontaneous remission, but nobody but me wants to raise their hope. When I feel hopelessness is so much more destructive ... Plus there are so many reasons for hope, it seems! So I'm happy to hear your thoughts on this!

Thanks!

Chris

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I'm reasonably sure that insurance would still have to cover physician's visits--people don't stop needing medical care when they are terminally ill.  Maybe it would not cover chemo, radiation, and other forms of anti-cancer treatment while he's in hospice, but palliative treatments might require a physician's care.

I found this in the FAQ of a hospice website:

What if a patient’s health improves while on hospice care?

Patients often improve with hospice services, because the focus of their care shifts to comfort, pain relief, symptom management and quality of life. They still have a terminal illness, but their symptoms are so improved that they no longer qualify for hospice services. A hospice must discharge a patient whose underlying disease or condition is no longer considered terminal. Patients can revoke hospice care for any reason at any time. Patients can also return to hospice at any time, as long as their doctor re-certifies their eligibility.

ETA: I'm very glad your uncle is doing so well.  Regardless of whether the cancer is "improving," what's most important is that he is more comfortable and has better quality of life--however long it lasts.  

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Hi Chris.  I’m sorry to hear about your uncle.  I cared for my father through Stage IV lung cancer.  It is a very difficult thing for all involved.  You didn’t mention if your uncle was going through any cancer treatments prior to his going to hospice care.  Cancer treatments can often be the cause a lot of other issues “symptoms” for people fighting cancer.  Once they are off those treatments those issues often go away and they appear to improve.  The other thing about people battling cancer is that small changes in their health tend to swing things dramatically one way or another.  A small cold for most people is tolerable, a small cold for someone with Stage IV lung cancer is quite a bit more serious and the symptoms a lot more pronounced.  It also means that once the symptoms of those illnesss pass their improvement is dramatic.  They may not produce mucus as they once did.  Some of your uncle’s symptoms could have been related to his stroke.  People who have strokes do tend to improve with time.  My father had oxygen available but did not need it.  He never had the gasping for air symptoms that many people imagine.  Your body also needs less oxygen as it starts to slow down. 

In terms of spontaneous remission there have been some cases reported but it is very, very rare.  The best advice I can give is to hold on to hope in all the places you can.  It sounds like your uncle is having better days then he has had in a while.  Don’t make them all about cancer, make them about something he enjoys.  Hold on to hoping for as many of those days as possible.  One day at a time.  That’s all any of us can do, cancer or not.   

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Chris,

Welcome here.

I note your uncle is receiving medical treatment in Germany.  Please be mindful that I am not a physician and more importantly do not have knowledge of the German Medical System.

In the United States, a hospice admission does not entail restrictions on physician care but it does restrict medical treatment to non-curative or palliative care.  Palliative care is performed to minimize symptoms, pain, or discomfort and would in the United States include both coverage for oxygen and lung and airway congestion relief. 

With that understood, to your question: is it possible to have stage IV lung cancer and experience relief from symptoms?  Yes!  Is there such a thing as spontaneous remission? Yes but it is extremely rare. It is however far more common to experience symptom improvement or stabilization sometimes for extended periods -- for months, even very occasionally years.

I hope this answers your questions and that your uncle continues to improve.

Stay the course.

Tom 

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