PRIMARY LIVER CANCER PALLIATIVE CARE

  • 2 replies
  • 12 subscribers
  • 350 views

My dearest uncle has been diagnosed with primary liver cancer over the last 2 weeks . He has been unwell for some time for over a year or 2  and drs haven’t really been helpful in working out the problem. They said the medication he was taking was causing him to have black outs but never referred for further tests. This was about a year ago.

 About 2 weeks ago he became very unwell with a cough and general weakness and  we were tired of the lack of help we were getting from the GP so we took him to A&E. After concerns from the blood test he was sent for a CT scan whilst in A&e to then be told he potentially could have liver cancer. We had no other info and sent home. We chased it up a few times ringing drs secretaries and the GP and they just said his case is being discussed and no further tests are required at this stage.  It has been the most horrific emotional waiting process anyone can imagine.

A week later we were told Leeds would discuss his case and learnt it was a MDT meeting that would be reviewing his case and discuss the next steps. The same afternoon after the MDT meeting we were contacted to ask to come in for a meeting in the hospital . They’ve given us the heartbreaking news he has stage 4 primary liver cancer which has now spread through the lymph nodes to other organs .  This was just about a week ago.

He is 70 never smoked never touched alcohol. the size of the tumour on his liver has grown rapidly. The consultant has said due to his bilirubin levels which are currently at 65 he is heavily jaundice and they are unable to offer any treatment apart from palliative care and pain relief to help with symptoms.

Prognosis is 3-6 months however within the last 2 weeks he has deteriorated and he is never one to complain about pain. He is just so caught up in his thoughts at the moment. He has all the symptoms from pain in his stomach sickness, extreme tiredness, increased jaundice and just not eating much and itchiness all over  

i  Wanted to ask if anyone else has had similar experiences and in terms of life expectancy  can deterioration be very fast?  It does seem that he is on a downward spiral I’ve read in some forums it can be extremely unpredictable. He is now struggling to eat at all and in the last two days all he wants to do is lie in bed and he is very tired and is really struggling  to get himself up and walk about. I just don’t know how much time he has left I feel like we will be blessed if he even reaches a 3 month survival mark. As a family we’re keeping him at home at the moment but hearing from a lot of people that deterioration can be quite intense and to consider a care home facility as we want him to be able to have his dignity in his final stages. I just don’t know what deterioration he will experience next and hoping if people can share some experiences they have been through. Any experiences will be helpful  thank you

  • It’s the not knowing what to expect or what is the sensible thing to do, isn’t it? 
    You hope for the best and it comes as a shock when it’s obvious that your loved one is deteriorating fast. 

    We thought my husband had several months ahead to enjoy as he was doing well and the tumours were being controlled with immunotherapy, but he had suddenly become extremely tired and incoherent and is unable to function properly. 
    We thought it was the pain relief meds being overdosed and he was taken into the Hospice for observation. Now I am  shocked to be told the symptoms are likely to be a progression of the disease. 
    it’s happened so fast and we are not ready. 
    I think I need a frank discussion with his care team what to expect next and how do we manage it the best way? How long has he got exactly and will he be aware enough to know where he is if he comes home? 
    Will I as his sole carer, be able to cope with the practical side of nursing him? 
    Your situation is so hard, but I thank you for posting as it echoes my dilemma, 

    We have to ask the medical professionals the hard questions, How long? What’s best? 

  • It really is happening so fast and your words echo exactly how we are feeling as a family and it is so difficult to stay strong in front of the loved ones going through it themself. I can’t begin to imagine how my uncle himself is processing what is going on. He hasn’t mentionned anything at all he’s so calm he must be in pain and discomfort but he’s staying strong for everyone around him. 

    One thing I will say is always write questions down so you don’t forget what to ask. I really went in pretty full in with questioning about his care and what would happen. I mean we have only been told over 3 weeks now that he was at stage 4 and the care team have really put things into place very quickly. My uncle is on the gold line now and they’re amazing. Any issues we have we just ring them and they take the pressure off us and arrange for the meds and a nurse to come out. Within this last week a hospital bed has arrived at home, his McMillan care team have put a fast track package in place. So on top of the 2 carers that come in that we arranged through adult social care, we now have 4 additional carers who come in as part of the palliative care team who have taken over the meds they give everything to him and help him with moving and going to the bathroom. They’ve offered night  sitters 3 times a week from when we need this although we haven’t really needed it at the moment. When I asked why there is so much care needed right not, the nurses said it does seem he is in the last few weeks of his life although it is hard to believe just yet  

    my uncle has started to lose a lot of his energy. Just wants to sleep all the time. He perks up when he sees people for a couple of minutes then just wants to dose off. He’s getting slightly confused now with whether it’s day or night. His mouth is very dry and he’s struggling to get up to go to the bathroom. These are small changes that have happened within the last 2 days. 

    The dr is coming today to have the difficult conversation with him about a DNR and whether he did want to go into a hospice if he becomes very unwell. I think at this stage the biggest support is the nursing team. Any question you have ask them. They have the experience they have seen these situations day in day out and they are our biggest form of help. Any advice you need, ask the district nurses they are the most amazing team. They have been our blessing in disguise.