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What to Expect as Cancer Progresses

Reviewed: Thursday, January 19, 2006

What Will Happen to Me as my Illness Worsens?

It is difficult to predict what each patient will experience because so much depends on where the cancer first began. Each person's response to cancer is different.

"How long do I have…?" That's often the first question patients and families ask.

Unfortunately, doctors are only able to give patients and their families an approximate idea of thier survival length. It is virtually impossible to provide a precise time frame for survival. As cancer progresses, many patients become weaker and are less able to function as they did previously.

What is Palliative Radiation Therapy and Chemotherapy?

When cure is not possible, both radiation therapy and chemotherapy can help to relieve the symptoms and to improve the quality of life. These treatments are used to shrink a tumour, or to slow down it's spread, so that while you may be living with an incurable cancer, you can still continue to live well.

What Else Can Be Done to Relieve My Symptoms?

To help you with your pain, or whatever symptoms you are experiencing, we will use medications as well as treatments that are not drug-related. Each symptom will be treated according to what is causing it, and how it makes you feel.  In this section you will find information on pain management, nausea management, anorexia/ cachexia syndrome, bowel care, and dyspnea.

Will I Suffer Much?

Pain and symptom management has come a long way since the past and has diversified in the approach that is now taken towards pain and symptom management. Your health care team will do whatever is possible to make you as comfortable as they can.

One of the most important things is that you let us know how you are feeling. Don't try to "weather through" your symptoms - often, how successful we are likely to be in treating your symptoms depends on us getting on top of things early.

In most cases, however, symptoms and pain can be well managed with fairly simple care plans. Only occasionally do we have to call in the experts, but we have them too if you get into difficulty.

Information for Families

This information will help you understand what your loved one is going through and to help prepare you for what happens during this final stage of dying.

Each circumstance is different and these signs and symptoms may not occur for everyone.

How Will My Loved One Die?

The most common experience is that terminal cancer patients become increasingly weak and drowsy and spend much of their time sleeping. Dying and death is usually quiet and peaceful.

Your care team at the BC Cancer Agency or in your community will help you prepare for what to expect and to do at this time. Don't hesitate to ask. Here are a few things that often, but don't always happen:

  • Comfort: Pain is seldom a problem as death approaches.
  • Breathing: It is common to see 10-30 second periods when breathing stops. This is often followed by a deep sigh. Gurgling or wet sounding breathing is often caused by a collection of saliva at the back of the throat, which cannot be swallowed because of weak muscles. If these are troublesome for the patient or family, things can be done to help lessen these symptoms.
  • Moaning: It is not uncommon for a person to make a moaning sound as they breathe out or as they move. This does not mean your loved one is in pain, but is the result of air passing over relaxed vocal chords.
  • Colour changes: The skin (especially limbs) is often bluish and discoloured as well as cool to the touch. This happens as the circulation slows down and finally stops—it is a natural part of the body shutting down.
  • Swallowing: It is very common that the person is too weak to swallow. It is not necessary to feed an imminently dying patient which may be hard for the family to adjust to. Remember they are slowing down and shutting down and they do not need the energy for their processes as we do. Time is better spent in giving good mouth care and providing general comfort for your loved one.
  • Vital signs: The pulse usually becomes weaker as the heart begins to fail.
  • Confusion: It is common for some type of confusion to be present. Dying patients may speak of, or to, loved ones that have died before them.