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End of chemo - how long now?

Posted 18 Sep 2018 at 12:34

Hi, my Dad was diagnosed with metastatic prostate cancer in his bones July 2012.  Over the last six years he has received pretty much every treatment available.  He finished his 8th chemo in July 2018.  In August he was advised not to do any further chemo sessions.  His options were limited to 1) doing nothing 2) doing a clinical trial, or 3) doing a different sort of chemo.  He went for option 3 and did the 2nd session last week.  He's been advised he'll probably only do 4/5 sessions in total.  This means chemo will end in Oct/Nov, treatment will stop and he will continue with care plan from the Palliative Care Nurse.  Does anyone out there have experience and advice on what happens between end of last chemo and 'the actual end?'  I'm looking for tips on what sort of pain relief options there are (he's currently using 50mg Fentanyl patches and lots of liquid morphine) but is still in alot of pain.  And would also appreciate anyone sharing the sorts of timeframes they experienced with their relatives.  Also, any tips on what to expect and how to prepare for the last few months.  Thank you so much.  R

Posted 18 Sep 2018 at 17:16
Tough question! I can only speak from the experiences of my dad from 20 years ago. Key players at that time were Macmillan nurses, the local oncology ward (where my dad finally died) and of course my lovely Mother who did the brunt of the caring . His GP was a waste of space but the other agencies were great but all of it needed a lot of work to stop him falling through cracks.

Keeping in touch with the ward, Macmillan and a local Hospice are key to minimising suffering and maximising enjoyable life.

My dad was lucky to have stayed at home and working on his various projects right up until a few days before he died. He was able to do this through regular blood transfusions and effective pain relief. What eventually "finished him off" was a spinal compression that left him paralysed, but he did not suffer I can say this with certainty because we had a system of hand squeezes agreed so even when he was semi conscious I could be sure he wasn't suffering. I am convinced that the morphine syringe driver actually killed him because he died just after it activated but I knew he was ready to go so it was a relief all round but I still mis him and his thoughtful insite on life....

Posted 19 Sep 2018 at 16:20

Thanks for taking the time to reply.  It's really helpful to hear others' experiences of what happens towards the end...

Posted 19 Sep 2018 at 16:54
People dont actually die because if the orostste cancer; they usually die due to organ failure because of mets to soft organs, or as a result of the increasing level of meds needed to manage pain (usually associated with bone mets) so they increasingly sleep until it becomes clear that they are slipping away. Or they are beset by an infection and cannot fight it (for example pneumonia or as a result of chemo). It is a minority that have very tortured painful deaths.

How long before you have to deal with the end stage? Some men will still be around 2 or 3 or more years after chemo, as long as the HT is still controlling the cancer. Some deteriorate very rapidly when no-one was expecting it. All I can suggest is create memories and say all the things in your heart, just in case the end comes when you weren't looking.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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