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Question
Posted by: Liefie | 2006/10/29

Pancreas Cancer

My husband was diagnosed with pancreas cancer stage 4 on 5 May 2006. He did receive a few sessions of chemo therapy and during August 2006 the cancer size decreased by approx half the size and the cancer count decreased from 1000 to approx 330. At the beginning of September 2006 he started not feeling well and his tummy also got swolen. We visited the hospital and sonar shown a lot of flueds in the tummy and surrounding areas. On the 8th of October 2006 a large clunt went thru and ended up in his lung. A little damage was done to his heart. By this time his tummy looks as if it is going to burst. He also battled to eat and most if not all came out again. The docter did not feed him per drip or any other way. He was sent back home the following Sunday. The next Wednesday 18 October 2006 I took him back to hospital as he was complaining of heavy pains. They started to drain his tummy that afternoon and more than 5 litres came out. They tested it and it proof to be cancer. The Friday morning doctor told him that no chemo is going to be given to him anymore. The hospital sister arranged for me to take him home for the weekend. He was still battling to eat as more came out after trying to eat. Early Monday morning he was curling with pains especially in the back. I took him back to hospital at approx 2H30 and they put him on a high dose of morphyn. He died that evening at approx 19h40.
I want to know if there was not something more that could have been done earlier. For instance to drain the flueds when we first complained about it. Why no feeding per drip was given to him when no food and water was accepted by his body. It feels as if the medical team gave up on him when there was still a change of saving him. I was so stupid not to read the signs and insist on the above treatment.
Please help me in understanding what was happening.

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Our expert says:
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Dear Liefie
Although the fluid in the abdomen looks as if you need to drain it, doing that causes the patient to lose a lot of protein and the blood pressure can drop dramatically causing shock - and it fills up again within a day or two. We only really remove the fluid if it impairs the patient's breathing. I worked in a hospice for 2 years and that is ideally where your husband should have been for the last few weeks, but it is not so easily accessable to all patients. Patients with end stage cancer do not really feel hungry as their whole metabolism changes. Putting him on a drip would not have nourished his body but may have rehidrated him somewhat. I believe that a patient should at least be made comfortable, given sufficient painkillers, and kept rehidrated, although it will not make much difference in his quantity of life, it may make a difference in the quality of the last few hours. Unfortunately, if you took him to a provincial hospital, due to the shortage of beds, they sometimes have to make the very difficult decision whether to save a bed for a patient that have a chance of recovering or admitting a terminal cancer patient - I'm sure if he could the doctor would have admitted him earlier. I know how I had to "fight" for a bed for a patient sometimes when I still worked at a provincial hospital!! There is nothing really you or the doctor could have done to save him - it was just a question of time and with pancreas cancer one does not want them to suffer for weeks with these pains. Chemotherapy only helps up to a point, and if the cancer is too far spread it does more harm than good. I know it is so difficult to lose someone you love, but I am sure that he knew that you did your utmost best to help him. It is normal and OK to feel sad and to miss him terribly, especially as his illness came so quickly, give yourself the luxury of mourning him - it can take up to a year to really get "over it". You may find that every 3 months or so you go through a "dip", feeling very blue and sad, it is also OK to feel like this, it is a way of coping with what has happened.

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