Need Info on Final Stages of Stomach Cancer

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Need Info on Final Stages of Stomach Cancer

by Sylviam on Thu Aug 17, 2006 12:00 AM

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I am new to this board and looking for some information for my terminally ill uncle whom we are trying to take care of. He already had a total Gastrectomy and at the moment is in a nursing home. HE was due to get out today but began to run a fever and has now admitted that he has no feeling in his right arm and the Doctors have said that this is part of the final stages. Does anyone know if these symptoms are part of the final stages? This is new to us and we were never told this before and we just feel like they are just saying anything so that they can send him home. Can anyone help me with some info on the symptoms he may begin to develop once his time gets near to the end? We want to be aware when they happen and the truth is it has all happened so fast and we have had so many questions that I have not found much info on this type of question online. Thank you to all! Sylvia

Thoughts

by Amnia on Fri Aug 18, 2006 12:00 AM

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Dear Sylvia, Gastric cancer is one of the most aggressive cancers, with a five year survival of close to zero. I am sorry your uncle is so ill. I hope he beats the odds and gets better. To answer your question, based on what you said, he most likely has a metastasis of the gastric cancer to his brain, his spine, or possibly his upper right lung (the latter pressing on a nerve plexus that goes to his arm). If I had to guess which one I would say it is more likely to be in the brain, on the left side, compressing the left sensory strip which interprets sensory signals from the right arm. An MRI scan of his brain would be a useful next test, and if it were positive perhaps the tumor could be shrunk a bit with brain radiation (which he has not yet had I would guess). However, based on a hunch I am guessing maybe he and his doctor have found other metastasis throughout his body or perhaps they have run out of treatment options, and that he and his doctor talked and they decided he has had enough treatment and does not want to endure any more. Perhaps he wants to be left alone by the medical community, made comfortable, and perhaps managed by palliative care at home surrounded by friends and family for the rest of what time he has left. You asked about future symptoms to watch for. If he has a brain metastasis that is getting larger, he may eventually begin to have seizures. A common final event that leads to death is any relatively common infection such as pneumonia that the patient is unable to fight off due to an impaired immune system, perhaps the result of cancer induced malnutrition. disclaimer: i made a lot of assumptions. perhaps talk to his doctor about anything you find interesting in the above discussion rather than acting or not acting on anything i have said. no one can diagnose or treat someone over a message board such as this. I often wonder why I respond to questions when my answers are so sad and hopeless. Re-reading my response I feel I must apologize to you. I am quite sad that I could not find anything positive to say. I hope everyone is wrong and that you and your uncle have a lot more time ahead to spend together, -Amnia

Thank You!

by Sylviam on Fri Aug 18, 2006 12:00 AM

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Dear Amnia, Thank you so much for your honesty, I am not looking to have any thing sugar-coated, I really just want to know what to expect. All of this happened so fast, we have only known close to 2 months, I does live alone at 81 years of age and we noticed that he started to lose lots of weight but never told anyone why. After constantly asking he finally told us that he was unable to eat because everything would get stuck in his throat and he had lots of pain, hiccups and constipation....I think he already knew what he had without really knowing and that is why he would not see a doctor. When we finally took him they knew right away from the tests and they operated immediately removing the entire stomach, splees, lymph nodes, part of the intestines and so on. They did say the cancer had spread and that they could not give him more than 6 months of life and that was if he radiation and chemo but they never really explaind what we should expect in the months to come. HE said he would go ahead with whatever they wanted to do but I really just think he says that to not let anyone down, I really do not think he is interested in any kind of painful treatments that will only make him sicker. No, he never had a brain scan and you may be right, it may have affected the brain or somewhere else, and others have have been through this same type of cancer could probably shed more light on what we are to expect or even if we should continue to have him tested or like you said, just try and make his final time more comfortable....we really just want what is best for him. Thanks again for you response, we really appreciate it and any other advice we can get. I am just curious if anyone else experienced this numbing feeling in the arms or any other part of the body? Sylvia

to Sylvia

by Want2bstrong on Wed Aug 23, 2006 12:00 AM

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Hi Sylvia, Sorry to hear about your uncle. Gastric cancer is indeed aggressive. I lost my beloved father aged 68 three months ago to gastric cancer that had spread to his liver. I can second Amnia's message on the pneumonia. My father had pneumonia in the end which his body could not fight. Then an X-ray revealed that the cancer had gone to his lungs. Take care and hang in there. Its a tough battle.

More Thoughts

by Amnia on Wed Aug 23, 2006 12:00 AM

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Dear Sylvia, Since I last wrote to you, I had a thought about your uncle's numbness. This is a long shot. But there is a chance his numbness could be do to something other than the spread of his cancer. If he had a brain scan and it showed a met to his brain, then all that I am about to say is just wishful thinking. If the scan of the brain did not explain the numbness, read on. Your uncle had a lot of plumbing removed. They certainly removed his stomach and possibly also removed the terminal portion of his small intestine called the "ileum." A stomach and an ileum are required for a normal person to absorb vitamin B12. The normal way this works is that something called "intrinsic factor" is made in the stomach and binds to b12 on the way to the ileum. in the ileum, the intrinsic-factor-bound-to-b12 complex is absorbed. Why is this important? Vitamin B12 is crucial to things like nerve functioning and making red blood cells. Giving Vitamin B12 by mouth as a vitamin pill or eating foods rich in vitamin b12 will NOT work in your uncle's case. I repeat, by mouth this vitamin CANNOT be absorbed by your uncle. It will pass right through him because there is no intrinsic factor to bind to it, and there probably is no terminal ileum anyway to absorb it (that is the only part of the GI tract capable of absorbing vitamin b12). Those plumbing parts were surgically removed. The only way to give him b12 is as either an IM injection or in an IV bag, perhaps mixed with other nutrients. It is easy for patients in nursing homes to get lost in the shuffle and if this inexpensive vitamin was not initially ordered to be given by a non oral route when he was admitted to the nursing home, it is unlikely he ever got it during his stay there. I have also seen idiot administrators get the pharmacy techs who do not know any better to change IM or IV vitamin b12 to PO (oral) once a patient is able to eat, because neither administrators nor techs understand the metabolism of vitamin b12 and how it cannot be absorbed by patients such as your uncle. (there is another class of patients that have a similar problem - it is called pernicious anemia, but i digress.) If your uncle is both anemic and having nerve problems such as numbness, it would not hurt to print this humble reply on paper and show it to your uncle's doctor. Your uncle is most likely already on vitamin B12, but if he isn't, perhaps vitamin b12 will make his end of days a little more comfortable. I am so sad for you and your uncle, -Amnia

Thank You!

by Sylviam on Wed Aug 23, 2006 12:00 AM

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P K., Thank you for your response and I am also so sorry to hear about the loss of your father, I hope that things are getting atleast a tiny bit easier for you to cope with. I also lost my father but to an Aortic Aneurysm 2 years ago and although I will never forget him and I think of him everyday, the saying "Time heals all wounds" has a little bit of thruth to it, it does get a little easier as time passes and although it may not seem like it at the moment, it does get easier. Lots of luck! I would apreciate any info that anyone may have so if you have an article on pneumonia I would love to read it since this is one of the things that the doctors are afraid of and that is of him getting pneumonia. Thanks again, Sylvia

Vitamin B12

by Sylviam on Wed Aug 23, 2006 12:00 AM

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Amnia, Wow, what a great piece! I am not a doctor or anything but it sounds very interesting and I will definately make sure to have my mother mention this to his doctors/nurses at the nursing home. I actually live in Chicago and he is in California but I have been back and fourth while I have left my mother there since she refuses to leave his side. I will have someone print this off for her and see what happens until I can get back there within the next week or two. He has now lost feeling in his right leg and can no longer use the mensroom so they were forced to put him on diapers, he has pretty much given up and is extrememly depressed and cry's often so I don't know how much longer he has to go. Thank you all for your responses, they are very helpful and I really appreciate it. Sylvia

Thank You!

by Sylviam on Wed Aug 23, 2006 12:00 AM

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My previous message was for want2bstrong, I am not sure where I got the PK. from.....I guess I am not seeing straight. Thanks everyone! Sylvia

Thoughts

by Amnia on Wed Aug 23, 2006 12:00 AM

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pk is want2bestrong's "other" screen name that cancercompass shows you in the box below the reply-to-message box when you are replying to any of want2bstrong's message. hey.. maybe call you mom and ask her to call her brother's doctor about the b12. b12 deficiency can cause permanent nerve damage if left untreated long enough. Keep us posted, -Amnia

Now i See!

by Sylviam on Wed Aug 23, 2006 12:00 AM

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Thanks Amnia, I knew I saw it somewhere but when I looked on the board I saw no traces of the letters P K. anywhere. My mother is expecting my call at 5:00 which is 7:00 Chicago time which is the time I call her everyday...I will give her the info and fill you guys in. Thanks again!
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