Expert: Claes-Gustaf Nordquist, M.D. - 7/11/2008

Question
Hi, My mom was diagnosed Aug of 2007 with lung cancer, with lumph node involvement. Had Chemo and radiation for 8 weeks then 3 more rounds of chemo. We took a break from chemo and within 2 weeks the headaches came and MRI showed 2 tumors in the bone of her head. One above the left ear, one on the right side of her forehead that broke through the bone and a lump shows on her forehead and it broke through on the inside where it is pressing on her brain. Also, cancer was found on the lining of her brain. May 12th we brought in Hospice and we are caring for her at home. Mom is very confused these days, fights hard to stay awake and she does but looks like a zombie, her kidneys are failing, her heart is strained by that. Inderol and lasix and aldactone were added to help. We believe the cancer is in her throat also, liquid and food go in but many times it comes out her nose and her voice is at a whisper. Her pain is controlled with Morphine and her breathing we use the morphine nebulizer. Her equalibrium is real bad despite the decadron she is taking. She is also becoming more incontinent. My question is as you probably expected, how much longer will she be able to hang on and how can we help her to know it is okay to let go. I think she is frightened because she has forgotten much of what has put her in this state. Thank you for any advice you can give us.

Answer
It is very common that lung cancers spread to the brain as here. It is not necessary that it is in her throat for this to happen. The fact that it has spread to her brain is in itself enough of an explanation. Her muscle control for swallowing has probably deteriorated due to that.
In this situation her expected survival time is at most a few months but can just as well be just a few weeks or even shorter. A certain relief of symptoms can be achieved with radiation therapy of the brain but it will only be temporary and no cure is possible unfortunately.