palliative care for non-small cell lung cancer

hi -- my husband was diagnosed 8 months ago with stage IIIB non-small cell lung cancer (March 21 2007) with superior vena caval syndrome (his SVC was almost totally occulded) with the presence of increased collateral circulation. One month later a repeat CT determined metasases in his liver and in August a bone metastases in his pelvis was found. He was intially managed with 10 treatments of thoracic radiation, followed by 4 cycles of cisplastin & vinrelobine. Midway through his chem he had a good response, however he quickly relasped post chemo -- his chemo was followed by 30 days of tarceva. He also received radiation to his left pelvis for a golf ball sized soft tissue mass + 2 cm hole in his pelvis. His tarceva was d/c after 30 days d/t hemotypsis + a very bad rash. Two weeks later he was admitted to a palliative care unit with increasing dyspnea and hemoptysis. He has been managed over the past week with Buscapan (up to every hour as required), Midazolam as required, and a continuous morphine drip with PCA. He still experiences respiratory symptoms -- in particular increased respiratory secretions after taking in any liquid and SOB -- are there other treatments we can explore to aid in his comfort and palliate his symptoms -- in talking with his nurses and physician they are anticipating at this point he has 36 to 48 hours left -- I feel very helpless as  although I am an RN my area of expertise is in L&D and NICU I am totally out of my scope of practice.

[bhumi123]

Hello,

I am very sorry at the situation you must be going through right now. All that can be advised at this point of time is that you let yourself be prepared for the inevitable. This is also to assure you that the measures you have mentioned are adeuate for palliative support in the said medical condition of your husband. As must have been explaned to you his condition is very critical. Hope that you keep up your strength through this tough time.