Metastatic Brain Cancer

Hi.  My stepfather was diagnosed with metastatic brain cancer last October.  He has had 15 radiation treatments, and will begin his third round of chemo.  Last week he had surgery for an Omnivor Reservoir becuase the cancer is now in his spinal fluid.  I'm not sure the true origin of the cancer - or the cancer type because my mom doesn't know, but after his first diagnosis, they found a tumer on his adrenal gland, one in his lung, one in his esophagus, along with 15 lesions in his brain.  Since his surgery last week, he's quickly getting worse.  He now has daily seizures, and falls frequently.  Yesterday his blood pressure spiked after a seizure which caused him to have a hard fall and hit his head on the floor.  My mother doesn't know what to do - she works full time, and has asked if I can stay with him, but it sounds like to me they need medical help.  When should he go to the hospital?  What types of home health care are available?  What should we / I do?  Are these signs of the final stages?  I feel so helpless and I'm afraid this is getting very close to the end and I'm very worried for my mother.  Any helpful suggestions would be greatly appreciated.
Thanks.

[Dennis MD]

Hi.
I understand what you are going through.
From your description, it seems that your stepfather needs to be admitted in the hospital.  He’s been having seizures daily.  An anticonvulsant needs to be given in case he’s not taking any.  Adequate seizure control should be achieved.  Once the seizure is controlled, you can already bring him home or to a hospice and palliative care facility.  A thorough discussion involving the family and his doctors (psychiatrist included) should be done.  End of life issues should be settled.
God bless you always.

[MilanMiller]

Thank you for your responce.  He is now in the hospital after his scheduled doctor's appointment yesterday - he was immediatly admitted.  They are also discussing a feeding tube.  The cancer is now in his spine and causing great pain in his back.  They are going to begin daily radiation treamtments - he will have 10 treatments daily on his back, and two daily chemo treatments thru the reservoir.  That seems excessive too me - but I am not familar to cancer and how the body can handle it.  I am also not sure about the feeding tube.  But all of this is very difficult to talk to with my mom.  I have tried to encourage seeking a psychiatrist, but they won't and haven't yet.  My stepfather refuses to discuss any end of life issues.  It's incrediably destressing.

My mom also said she has never seen anyone go down so fast - can cancer do that and really spread that fast?  I saw in last week - he was "ok" - but now mom says he's fading quickly, daily.  

[MilanMiller]

I mis-spoke.  He's having 10 radiation treatments over the next 10 days - daily and during that time two chemo treatments.  I missunderstood.  There is a tumer growing in the L2 vertebrae and putting pressure on his nerves.  The readiation is to shrink that tumer.

[Dennis MD]

Hi.
I admire your courage in going through all of this.
Cancer behaves differently.  It can be very aggressive, or it can be indolent.
Chemotherapy and radiation therapy both have side effects.  Patients do experience anorexia during treatment or several days after treatment.  The feeding tube can help in improving his nutritional status.  
Aside from the management you mentioned, your stepfather will also benefit from pain management.  Adequate pain control should be achieved.
I wish you all the best.  

[GeezLouize75]

Has your family contacted your local hospice organization?  They are experts in end of life pain management.  Good luck and God Bless you and your family.

[kimmie240]

My mother has metastatic lung cancer and it has spread to her brain. The primary tumor is on the tempral lobe.The other are many lesions.This diagnosis was 09/18/09.She is having much difficulty walking unassisted.She has fallen 3 times.Her hands shake badly and is having trouble with conversation and not being able to find the right words.She becomes confused real easily.She is 73 and was avery young 73 until about a month ago.She says her balance is very bad.I am her only caregiver and am about 45 min. away. I take off work for loads of appts. ect. She wishes to pass away at her home and I am determined to grant that wish.She has life alert. I don't know when I should start family leave and care for her fulltime?I do not know how much time she has left and worry about taking FLMA too soon and running out of time.If I enlist Hospice they require someone to be there fulltime and I wish she had alot of time left but I am trying to prepare for the truth.Has anyone been in this situation before.I am just lost. Any answers?I know she has gone downhill very rapidly in the last month.It is somewhat of a financial situation for me as well.