Life Support Issues/Primary CNS Lymphoma


My mom was diagnosed with primary CNS lymphoma (stage 4) in April (about 6 weeks ago). After one round of methotrexate the cancer progressed. The doctors were not optimistic about Whole Brain Radiation as an alternative because of her age (66), the late stage of the cancer, and the comparative MRI. She has now been in hospice for about 3 weeks. At first, death looked imminent and we braced ourselves, but since then, she has 'bounced back' quite a bit and I'm wondering if the doc was wrong - or if we should try to get her back in for some kind of treatment - more chemo, radiation, or? The other dilemma is, all the aggressive parts of her personality are now coming back with a vengeance and we are all at a loss for what is actually happening, what to expect, etc? Has anyone seen a loved one go through this - what was the dying process like? OR Did the person make a recovery? Thanks!


I am so sorry about your mother.  This site is not really a forum where you can get collaboration with other family members of cancer patients. I am a hospice nurse and can only share my 25 years of experience with you. I see there are forums on the Internet such as but have never utilized them.

I have seen hospice patients temporarily improve after treatment. I have never seem one cured of their disease. This is a particularly rare and aggressive disease. Here are some thoughts to consider.

I would rule out pain as the cause of her aggressive behavior. Patients who cannot communicate their pain will often be irritable or restless. Poorly managed pain, in time will cause her to hurt all over, such as when she is simply touched! So ask the hospice nurse to evaluate her for pain.

Constipation can also cause aggressive behavior and the hospice nurse can evaluate her bowel status and remedy that situation.

You can ask her oncologist why she seems better now. How does that affect her overall prognosis, so you can prepare.

Finally, signs that she is getting worse are: is she losing weight and becoming weaker? Patient approaching the end of life usually have trouble swallowing and eating which leads to weight loss.  The are increasingly less able to care for themselves and require increasing amounts of "hands on" care. Their mental status declines and they are less able to communicate and they sleep most of the time.  

Life Support Issues

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Betsy Murphy


My expertise is in end of life care for adults. Identifying when someone is approaching the end of their life. Benefits and burdens of end of life treatments. Managing pain and other symptoms. Providing care for dying patients at home. Advocating for someone who is dying in a hospital or nursing home.


More than 28 years of experience in hospice care. Currently consulting with hospices to promote access for patients to receive hospice care earlier in the course of their illness. Betsy provides training for hospice marketing staff to effectively work with nursing facilities to help identify eligible patients. She writes Additional Development Request (ADR) letters to Medicare to help hospices get paid for their services and to avoid future claim denials.

Hospice and Palliative Nurses Association

Articles: Clinical Reviews, Advance for Nurses, Nursing Spectrum, Washington Business Woman,; Understanding Medical-Surgical Nursing (FA Davis and Company), Guide to Caregiving in the Final Months of Life (TM Brown publishers).

Bachelors of Science in Nursing, additionally trained as a Family Nurse Practitioner and certified as a hospice and palliative care nurse.

Awards and Honors
Outstanding Woman in Loudoun County (VA) by Loudoun County Commission on Women 1997 and 2002.

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