My Mother Has Stage Iv Stomach Cancer. What Can We Expect Next?

My 68 year old Mother was diagnosed with stage IV adneocarcinoma with metatisis to lymph nodes and the outside lining of her abdomen. She has received her first IV chemo cocktail of cysplatin and epirubisen and is now taking Xeloda orally. The treatment was last Wed and just today is she finally able to sit up without nausea and finally able to eat small amounts. Her tumor is inoperable and the Dr hasn't mentioned radiation. She was being treated for 4 bleeding ulcers prior to cancer diagnosis. Can anyone tell me what to expect? I am 48 years old and her primary caretaker. The rest of my siblings have jobs and young children to care for, so this job falls on me. I actually live 7 hours away, but have moved in with my Mom for however long it takes. I am a very strong person, but would appreciate any advice or help. I feel very helpless and at the mercy of others for information. Is this survivable?

my mother is 67 and has stage 4 signet cell adenocarcimoma. she has had 4 months of cisplatin, epirubicn, and flouricl. when attempting to remove her stomach they aborted her surgery because it spread to outside of her colon. usually by the time stomach cancer is diagnosed it has already progressed. my mother has been given 6 months to 1 yr, and we will fight the whole way. it is hard for her to eat, she throws up bile all the time, and she is on tpn through her port for feeding.

we are looking for alternatives, knowledge is power and the to win the battle of cancer.

i will pray for our mothers--

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blessings,
carla

Q: "Is this survivable?"
A: Generally stomach cancer that is stage IV is not considered curable. Generally the purpose of treatment is to prolong a person's life.

Q:"I feel very helpless and at the mercy of others for information"
Generally the average life expectancy of a person with stage IV gastric cancer who undergoes treatment is on the order of about a year. Without treatment the life expectancy is about half of this. Generally the five year survival of a person with stage IV gastric cancer is on the order of 4%. These are only averages. You mom's life expectancy might be much shorter or much longer than this.

Q:"Can anyone tell me what to expect?"
I bet she does not get most of the things on this list. Things that are possible might include:
- side effects specific to the chemo she is getting. For example, 5-FU causes mouth sores in some patients. Others lose their hair.
- loss of appetite
- weight loss
- nausea
- vomiting
- diarrhea
- depression, anger, bargaining, denial
- abdominal pain
- anemia
- infections
- hospitalization (for dehydration, pneumonia or any of a number of other complications)

Thank you for your thoughts and prayers. Yesterday my Mom was hospitalized due to pain in the chest, back, and her left arm. Today, they removed 2 1/2 pints of fluid from her abdomen to check for malignancy. Her oncologist has told her that she may not be able to continue with any treatment. We will learn more tomorrow.
We are looking for alternative treatments, if not life sustaining, then at least life comforting.

I will pray also for all of those that are affected by this horrible disease.

Dear Amnia,
Thank you for your response. You seem to know so much about this disease. Are you in the medical profession?
So far you have been right. Mom has not lost her hair, but she did have so many of the other side effects, including hospitalization for 8 days, due to pain in her chest, back, & arm. I think this was actually refered pain due to the tumor. Her sense of taste and smell changed dramatically, but seem to be improving. Today, she her questions turned to her survival and how long she may have to live. This is hard since of course we just don't know. How do you answer these questions? Do you pretend that she will get better. Her doctor has told her that she in not curable, but hasn't given her any time frame. Any suggestions on how to answer this one? Do I tell my Mother her survival rate or act as though I don't know. Is ignorance bliss?

You: "So far you have been right."
Me: I get that all the time. I am very sorry to be right in your mom's case.

You: "Do I tell my mother her survival rate or act as though I don't know? Is ignorance bliss?"
Me: Generally, people don't ask until they are ready to know the truth. Some people never ask, some ask just weeks before they die.

There are many opinions on this. Some feel that not knowing is worse than knowing. At least knowing, one can make better plans for the time on has left. Others feel that not knowing is better, perhaps for very young children.

If you are asking my personal opinion on this very complex issue, I believe strongly in telling the person the truth, but only if they ask for the information - an indication to me they are ready to know. Having said that, I do not think you should be the one to tell her. That is the oncologist's job, let him take care of that.

Cancer patients are just like everyone else and often "shoot the messenger" when horrible news is delivered. You do not want to remind your mother she is dying every time she sees you when you walk in her room, and that is exactly what will happen if you decide to deliver the bad news.

Have the oncologist tell her. If you like, you can be present and your mother can cry on your shoulder and talk it out with you after he leaves the room.

Other opinions on this issue are invited,
-Amnia

Thank you for your candid answer as to who should be the one to answer the question of longevity for my Mom. At first I thought it maybe should come from someone who loves her, but you helped me to see that it is probably better coming from the doctor. She has an appointment on Tuesday at which the doctor will tell her if she can withstand another round of chemo and she is planning on asking him what time she may left. She asked me if I want to know and told her no, not really, that I would just take each day with her and count it a blessing. Besides, I do believe in miracles! However, it would be easier to know what will happen next. She is up and moving about, but has much more pain than she lets on. She refuses pain meds at this time unless she just can't stand it. She does not eat much and drinks very little. She has pain in her back, but I'm not sure if that is from the disease or lack of activity. It is hard to know just how much to push to get her to eat, drink, and move about. There should be a book written that says, "do this, expect this".

excerpt:
"At the time, he was one of the world experts in stomach cancer and I was a young oncologist on the staff. George developed what looked like incurable stomach cancer. And he insisted on being aggressively treated. I thought he was, essentially, out of his mind. Eighteen years later, when I wrote the book, I interviewed him and told him if I had been his doctor, he would have died, because I had written him off. He explained to me that he had the right to hope. That he needed to try, he needed to struggle, he knew the odds were long, but that nothing in medicine, or biology, is written in stone. If you are in that small fortunate group that makes it, and you never know, then it’s 100 percent for you. So did hope save his life? Yes."

full story:
http://www.msnbc.msn.com/id/4269238/

from a book you should read:
The Anatomy of Hope: How People Prevail in the Face of Illness, by Jerome Groopman

if you read the article, pay close attention to the discussion of "false hope" and "true hope."

Jerome Groopman is a Harvard Medical School Professor.

My best friend had stomach cancer.She was 42 years old.Her tumor they said was the size of a fotball at the time when diagnosed,they did surgery to remove but knew it was not curable,she did 2 rounds of chemo and could not tolerate it and no more after that.They kept telling her she had 6-9 months,she lived almost 2 years with it.I truly believe it was her will to have more time that kept her alive.She was on ALOT of pain medicatiion,but did quite well until about 1 month before she died.And she could still talk until about a week before she passed.I was with her throughout all of this,so if anyone has any questions feel free to email me.

Thanks for book suggestion. I will be going to the library tomorrow. Today my Mother had her doctor appt. Her white blood cell count was up to 3900 (s/b 4000)so tomorrow she will have her 2nd treatment. No more cisplatin or epirubisen though. This time it is 1 week of Xeloda and 2 trmts of Taxotere 3 weeks apart. Do you know anything special about these drugs other than what the nurse told us today? She has really been feeling good and eating better for the last week. Her hair has begun to fall out, but that is a small price to pay.