Liver cancer with mets- prognosis

My husband is a 57 yo caucasian with hx of Hep C (treated but not completed due to blood dyscrasias), severe cirrhosis, esophageal varices and stage 4 liver cancer with metastases to the lymph and the abdomen and neck.  For about 3 months now he has been having problems eating initially attributed to his pain which was not controlled (he refused to go to MD).  Since then he has seen the oncologist and is on Fentanyl (100 mcg) and Dialudid 4 mg Q4h.  They gave him compazine as he was having a tremendous amount of nausea and vomiting but it was not 100% successful.  For about the last 6 weeks he has been unable to eat more than 2-4 tablespoons of cereal or 1-2 bites of food a day.  He is not on any specific cancer treatment at this time and I feel that starting something like Nexavar would be a BAD idea.  With him in such a debilitated condition, not eating (maybe 200-300 calories a day at most)  I feel his side effect will be atrocious and with not eating I don't think he can last more than another 3-6 wks.  What do you think?
Laurie

[Dennis MD]

Hi Laurie,
I understand what you are going through.  Chemotherapy is not started on patients with poor performance status and/or poor nutritional status.  The side effects of treatment (fatigue, body weakness, anorexia) would be more detrimental to the patient.  For the time being, your husband would benefit most from supportive management like providing adequate pain control, improving nutritional status, alleviating the symptoms being experienced.  Patient’s comfort is of utmost importance.  
Regards and God bless.    

[lilsis551]

My brother also had Hep C, cirrohosis of the liver, liver cancer that spread to his bones and blood.  He hardly ate and was losing weight everyday, and wanted to try anything to help himself live longer without losing any of the quality of life he had left.  He was told his cancer was terminal, and a week and a half later he started on Nexavar.  He took it for nine days before he started to vomit blood.  We strongly believe that the side effect of vomiting from the nexavar contributed to ruptured esophageal varices.  He died 36 hours later. My brother was also 57 years old.  Spend quality time with your husband and do whatever you can to make him comfortable.  God Bless.

[bob1932]

You need hospice to come help you and him. It's amazing how much help and comfort they are -  and how your life and your husband's life will improve - even if it's a short period of time. A lot of people are on hospice for years these days - it's not like the old hospice that only comes the last few weeks of life. My husband has improved since under their care - over a year now - and I know it was because of their involvement. You can find them in your community in the phone book or online - or call your local hospital.
Good luck to you.

[Ownlyanangel]

Have a G tube put in so he can get nutritional support