how do we help with lung cancer

My mother in law was diagnosed last year with lung cancer. By December 2007 she was diagnosed with spots in her spine and ribs. By January 2008 she was diagnosed with spots on her brain. She is unable to breathe without oxygen and has been at home since February 2008 on 24 hour oxygen. She has a vile cough that is persistent. She coughs all day long - a raspy fruity cough. She is also in considerable pain behind one of her breasts which is larger than the other one. Apparently the cancer in her rib has caused a break or fracture in this rib. She does not eat very much but insists on getting up each day, she gets dressed and sits downstairs sleeping or reading. She takes paracetemol every 2-4 hours and oramorph every 4 hours. The doctors just say there is nothing they can do to help her. What are your views. Any advice or help appreciated

[HeinrikMD]

Hi,

There are no clear options for cases with advanced disease in which daily living is highly affected by lung cancer. Conventional chemotherapy may indeed be difficult for such cases due to the toxicities associated with such treatment.
There is a drug called erlotinib which has a different side-effect profile from conventional chemotherapy. The usual side-effects are a rash and diarrhea. There are particular subtypes of lung cancer which may have a better response with this drug (and non-smokers seem to benefit from it more than the smokers) . There are patients who improve with symptoms on erlotinib (such as cough), however, extending survival may not be achievable on the average. There are a few who would have a dramatic response and may be able to regain much more in the way of daily activities. Perhaps you could discuss this treatment option with your doctor if it is available to you.
Stay positive.

[robin51]

Thanks so much for your help and advice. The swelling behind her breast is fluid which they cannot drain off. This is now in both her legs and ankles. It is so cruel. There is no treatment for her at all.  It is so unfair. What will happen next?

[HeinrikMD]

Hi,

Its hard to say what happens next. The fluid being present elsewhere is likely part of wasting or muscle mass, and there is leaking of fluid under the skin. The presence of the fluid may make the skin more vulnerable to damage, as healing under these conditions wouldn’t be easy. It may be a good idea to keep an eye out for skin damage. If she is lying on her back all the time, there may be considerable damage there already. There are some beds that may afford better support, shifting her body position every few hours would also be important.