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What to Expect as Cancer Progresses

Revised December 2014 

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 their expected survival duration. 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 than they were previously.

What is Palliative Radiation Therapy and Chemotherapy?

When cure is not possible, both radiation therapy and chemotherapy can help to relieve symptoms and to improve quality of life. These treatments are used to shrink a tumour, or to slow down its 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.  On the BC Cancer Agency website you will find information on pain management, nausea management, anorexia/cachexia syndrome, bowel care, breathlessness and other symptoms you may be experiencing.

Will I Suffer Much?

Pain and symptom management has become much more effective over the last few years. There are many options for different kinds of medications to help you to feel better. Your health care team will do whatever they can to make you as comfortable as possible.

One of the most important things is to let us know how you are feeling. Don't try to "weather through" your symptoms - often, the success of your symptom treatment depends on us starting early.

In most cases, symptoms and pain can be well managed with simple care plans. Occasionally we call in the experts, who are available if your pain or symptoms are complex.

Information for Families

This information will help you understand what your loved one is going through and help prepare you for what may happen.

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 patients with very advanced cancer 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 what 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 and is not painful.

Swallowing: It is very common that the person becomes too weak to swallow. It is not necessary to feed a person who is imminently dying. This may be hard for the family to accept. Remember that the person is slowing down and they do not need the same energy for their metabolism as a healthy person. Being too pushy with food can be harmful. 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.

What steps do I take after a death?

Your care team at the BC Cancer Agency or in your community can tell you what to do and who to call after your loved one has died. It is best to plan for this before it happens. This is a part of Advance Care Planning. It can save a lot of stress and upset for both patients and families.

With regard to legal matters, people can have varied roles. You may need to ask for the help of an expert.

For more information read and print the BC Cancer Agency information sheet called “Things to do After a Death.” Find the information sheet on our Practical Support webpage.