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As Cancer Progresses

This is a difficult time for loved ones. As cancer progresses, many patients become weaker and are less able to function than they were previously.

As Cancer Progresses - Patient Handout

It is difficult to predict what each patient will experience. It 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 almost impossible to know a precise time frame for survival. 

It can be helpful to know about some signs and symptoms as cancer progresses.

Cachexia (sounds like "ka-kek-see-a").

Cancer-related cachexia is a syndrome often seen in advanced cancer when a person has symptoms such as weight loss, loss of muscle, loss of appetite, and weakness.   

Cachexia can occur due to changes in your body because of your cancer or because of increased energy needs, decreased appetite, and increased muscle and fat breakdown.   

Cancer cachexia is different than regular starvation because it cannot be reversed by eating more.  

Focus on the pleasure of eating and tasting food.  If tolerated, you may benefit from eating small, frequent calorie dense meals. 

See our nutrition handouts for tips on eating with a low appetite. 

For advice on what to do if you are losing weight ask to speak to a registered dietitian at your cancer centre.  

You can also speak to a registered dietitian at Health Link BC by calling at 811 from anywhere in BC.

When cure is not possible, 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. S while you may be living with an incurable cancer, you can still continue to live well.

To help you with your pain or symptoms, 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 website you can find information about pain management, nausea management, 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 medication options 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 live with your symptoms. 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. We can also call in the experts if your pain or symptoms are complex.

This can be a difficult time. You may find it helpful to know what to expect. 

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

Each person 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 BC Cancer 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. This saliva cannot be swallowed because of weak muscles. If these sounds bother 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 move. This does not mean your loved one is in pain. It is the result of air passing over relaxed vocal cords. 
  • 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 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 BC Cancer 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.

More information is available on our patient handout titled "Things to do after a death." This handout is available on our resources page

Recommended websites: Advanced Cancer WebsitesManaging Symptoms and Side Effects WebsitesHome Care WebsitesPalliative Care / Hospice Websites

BC Cancer Library pathfinder: Advanced Cancer Pathfinder

BC Cancer pamphlet "Eating Challenges with Advanced Cancer," available on the nutrition handouts web page

BC Cancer information about medical assistance in dying (MAID)

Revised Dec 2014

SOURCE: As Cancer Progresses ( )
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