PROGNOSIS

MY WIFE HAD A SEMI RADICAL MASTECTOMY IN 1979.  SHE WAS DIAGNOSED WITH METASISED CANCER AGAIN IN 1989 IN HER LEFT LUNG.  BOTH TIMES SHE RECIEVED CHEMO CONSISTING OF CYTOXAN, METHOTREXATE, AND 5-FU FOR ONE YEAR PERIODS.  SHE WAS ALSO TAKING TAMOXIFIN (tamoxifen) FOR NEARLY 15 YEARS.  OUR SITUATION IS THIS.  THE CANCER REAPPEARED AGAIN ABOUT FIVE YEARS AGO.  SINCE THAT TIME SHE HAS HAD MANY TYPES OF CHEMOTHERAPY, NAVELBINE FOR A YEAR UNTIL IT STOPPED WORKING.  SHE CURRENTLY HAS METASISED CANCER IN BOTH LUNGS AND BONES. SHE HAS HAD FLUID REMOVED FROM THE PLURAL CAVITY AROUND HER LEFT LUNG TWICE IN THE LAST THREE YEARS. HER ONCOLOGIST WAS GOING TO PUT HER ON SOME KIND OF HORMONAL THERAPY UNTIL HE RECIEVED THE SURGEONS REPORT FROM HER RECENT SURGERY.  SHE TRIED TAXOL, TAXOTERE TWICE, BUT HAD VERY SEVERE ALLERGIC REACTION WITHIN A FEW MINUTES OF STARTING THE IV.  NOW SHE IS RECEIVING GEMZAR, 5-FU, DEXAMETHOZONE, ANZEMET, AND SOMTHING ELSE THREE WEEKS ON AND ONE OFF DEPENDING ON BLOOD COUNTS.  ALSO GETTING AREDIA ONCE A MONTH.  THREE WEEKS AGO SHE HAD A BI-LATERIAL SOMETHING OR OTHER WHERE THEY REMOVED 2 LITERS OF GELATINOUS FLUID FROM HER LEFT LUNG AND ONE LITER OF FLUID FROM HER RIGHT, AND USED TALC TO KEEP FLUID FROM COLLECTING THERE AGAIN.  THE SURGEON SAID SHE HAD "MUCH TUMOR" ON HER LEFT LUNG AND IT COULD NOT BE RE-EXPANDED.  HER RIGHT LUNG HAD "A LOT" TUMOR ALSO.  SHE IS ON PAIN MEDICATION, CHEMO, QXYGEN 24 HRS PER DAY, AND IS VERY TIRED AND DEPRESSED.  WHAT ELSE CAN WE DO? AND HOW LONG DO YOU THINK SHE MIGHT HAVE, BEST GUESS.  THANKS FOR LISTENING

[CCF-RN,MSN-JS]

Dear Fisherman, It sounds like you and your wife have been through an awful lot.  The goal of treatment of metastatic breast cancer is control of the disease, and symptom management.  With this goal in mind, when making decisions regarding treatment the pros and cons are based on will this add or detract from a person's quality of life.  For instance, if the chemotherapy is adding side effects and not contributing in terms of controlling the disease or symptoms, perhaps continuing may not be helpful.  There are services available which may be of benefit to you and your wife such as Hospice care, where the focus of services are aimed at symptom management and support to the patient as well as caregivers.  In terms of your wife's life expectancy it is impossible to say, she has a life threatening disease that has effected major organs, management of symptoms and her comfort should continue to be the focus of her care for however long that is.

[healthcareguerilla]

What an ordeal for you both. I offer to hold you in my prayers. Do both of you have someone to talk with? Hospice volunteers can be very helpful when one is dealing with chronic illness, and, I'm sure you know of others. Do either of you get any chance for some relief from the day-to-day dealings with illness? Different things work for different people, as you know...talking, music, nature, just being quiet (the hardest, perhaps)... I'm sure you've read that some people get a break by watching Marx Brothers movies, and the like, with humor being a help. I think that one of the trickiest things can be the fine line between being there for someone and yet not making them feel as though they have to take care of OUR feelings, in addition to their own. Again, perhaps a call to Hospice might yield some guidance. Peace to you.