End of life

My father was diagnosed with lung cancer in his left lung in December 2019. It had spread to his lymph nodes in his chest and he also has secondary tumours in his spine.

He initially had chemotherapy, radiotherapy and immunotherapy. He is now only on immunotherapy every six weeks.

The past six weeks his pain has worsened. He describes it to be like a tooth abscess all over his body but particularly bad in his left hip and leg. He also has pins and needles in the leg. He is struggling to walk.

He is complaining of feels so tired all the time and spending most of his time in bed with a hot water bottle on his neck.

He has this week been referred to the palliative care team who have prescribed him amitriptaline. He is also taking 30mg Zoromorph BD and 2.5ml oromorph every 4hrs! He says this still isn’t touching the pain.

Is this the beginning of the end? The lung specialist nurse reviewed his mri scans for me and she said the cancer is aggressive and he could only have months of not weeks to live in her experience!

woujd you agree from reading those symptoms and what other help for pain can they give hun.

Thanks in advance,

Jane

  • Hi Jane,

    Thanks for getting in touch at such a difficult time. It is hard to process new information when told cancer is not responding to treatment. Especially hard when also told that your father’s prognosis could be weeks or months, as a result.

    The nurse specialist is best placed to give this news, as they have access to scan results and can compare cancer growth, when looking at previous scans. They also are assessing your father and cancer symptoms, each time they meet or chat over the phone. Although I am unable to offer an opinion on life expectancy, perhaps you could talk to the consultant if looking for more information.

    I am sorry to hear that pain is increasing recently and that the combination of analgesia is not helping. The palliative care team are experts in pain management and will continue to change medication or increase doses, until pain is under control.

    Perhaps you can call to update them that pain is not settling and ask what the plan is going forward? If you are unable to reach them due to it being a weekend, you can call the 111 service. They will assess and prescribe something to ease pain.

    Amitriptyline is used for a specific type of pain, called nerve pain. It can be difficult to treat and can take a combination of analgesia to get it under control.

    This type of pain in the hip and leg, is particularly worrying, when cancer is in the spine. Even more so when also having a pins and needles sensation and struggling to walk. An assessment is needed to determine if these symptoms are due to a condition called – Malignant Spinal Cord Compression. You mention MRI scan results, these would give this information.

    This condition is treated urgently with steroids, to help maintain sensation in the legs.

    My advice is to call the 111 service now to get your father assessed for this.

     

    If you have another questions, please don’t hesitate to get back in touch on this platform or by calling us on the support line.

    Best wishes and take care,

    Kirsty

    Cancer Information Nurse Specialist

  • Hi Kirsty,

    Thank you very much for taking the time to reply. I will do what you have suggested.

    Thanks again,

    Jane