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bokurai35 karma
I'm watching my dad rapidly decline from terminal pancreatic cancer. Very open-ended questions, but...
1) Any advice for us (patient/family)?
2) Anything you've learned that you wish you had known in retrospect?
3) Anything you'd have done differently?
bokurai3 karma
Thank you for your detailed response, Kyle. Yeah, you can curse on Reddit. :)
Please forgive the long response, I obviously have a lot to say on this topic:
How old was your mom when she was diagnosed? 3 years is a long time to live with this disease, from what I understand, so it seems like she was either lucky, or tried a lot of different treatments that did end up prolonging her life, somewhat. Is that the case?
Like you, I'm in my early thirties, and my dad, who had me later in life, is in his early 70s. He has lived decades longer than many men on his side of the family have, and is quite stoic; feeling that he's lived a good life and has been lucky to reach his current age. As a result, I think that it is easier for him and us, his family, to accept that this seems to be how his life will end.
Similarly to many people with pancreatic cancer, my dad wasn't diagnosed until it had metastasized to other areas of his body, and is not considered a candidate for surgical removal. While he's currently scheduled to undergo weekly chemotherapy treatments, the hope is that it will simply slow the cancer's spread and reduce the size of the existing tumor(s) in order to improve his comfort level.
Even 4 weeks after diagnosis, I've seen a significant decline in his comfort and activity level. I think that if he were younger, and it felt like we had more time to experiment, I would feel more of the desperation you describe to urge him to try everything in order to prolong his life.
I'm sure it always feels way too soon to lose a parent, no matter your and their age!
As it stands, my primary concerns are to be the best caregiver I can to him on a day-to-day basis, make sure he's as comfortable as possible, and to support his wishes, whatever they may be, until his final breaths.
At the moment, I'm primarily worried that despite the pain and anti-nausea medication he's prescribed, he still seems to be in discomfort much of the time. I'm not sure how much drugs can accomplish, but I hope a higher level of pain and nausea management is possible. He's hardly eating, and has trouble keeping a lot of stuff down. He's also quite conservative when it comes to taking medication to begin with (and always has been). In his position, I'd be popping pills liberally, as long as they were within prescribed parameters.
I recently filled out the forms to apply for in-home palliative care, and hope to have him evaluated in the next few days. It would bring some peace of mind to have a medical professional visiting regularly to adjust his dosages to optimal levels.
As we are Canadian, he may end up going out via MAiD, and we recently submitted the forms for this.
As emotionally painful as the end will be, in whatever manner it happens, I feel like it would be easier to know that he left own terms when he felt ready than to watch him waste away to nothing, as you described with your mom.
Did your mom decide to fight the cancer to her final breath? Was her choice necessitated by a lack of right-to-die legislation, or one she made deliberately?
bokurai53 karma
In Canada, MAID does require two medical professionals to sign off on the decision, and the patient to be made aware of all other options available to them (such as palliative and hospice care).
A patient who has registered for MAID and gone as far as to schedule a date can also change their mind about undergoing the process at anytime, even right before the injection is administered.
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