Expert: Claes-Gustaf Nordquist, M.D. - 5/16/2007

Question
Hi,
My Mother in law (61) had breast cancer four years ago.  removal of breast, chemo, radiation.  Overall average to bad health.  Recurrence in spine about one year ago - although they delayed seeking treatment for 7 months.  The spine is severely degenerated, therefore, she has limited ability to walk, control bowels, etc.  Tumors are also in her lungs.  She was recently hospitalized for congestive heart failure with 750 ml being drained from each lung.  She is currently doing chemo and had radiation to her spinal area to slow growth in hopes of restoring some spine function.  She's also doing hormone therapy.  Here's the question: how long does she have?  I know recurrence is 20% to five years, but I'm hoping to hind something more specific to her case.  We have asked this question to her oncologist, but he doesn't want to answer.  He says "we'll talk about that later...."  We need to know so we can plan visits and make appropriate financial decisions (home care vs. nursing home, etc.)  Thanks for your time.  

Answer
It is impossible to give you any kind of time table! Just too big individual variations (that is part of the reasons her drs. do not want to talk about it, the rest is ethical). However with this kind of situation she is clearly not curable and her cancer will sooner or later kill her unless her heart or something else does (the drained pleural fluid you mention may in fact have more to do with her cancer than her heart). My personal educated guess based on your description is that she will at most live a number of months more, but I may be wrong either way (either over- or underestimating the time).