Life span with gastric tube and palliative care

We have been through the entire process with my mother over the past 3.5 years and she is now diagnosed terminal with no more treatment options remaining. She will be discharged to home shortly with the gastric tube and has been told 10 percent at best of the contents of her stomach will process food. She will have IV hydration 12-24 hours a day.

My question...how long can she survive with virtually no nutrition? The doctor said the TPN she gets in the hospital would do her cancer more good than her so he doesn't want it post-discharge.

It would help if we knew if it was a week versus a month. She doesn't want to know, but I do.

[Annekathryn Goodman, M.D.]

Hi There,

what a hard road your mother and you and your family have been on.  It is a very tough transition to go from active therapy to end of life care.  Without knowing the details of your mother's case, I am guessing, based on the recent decisions of her doctor, that she has a blockage in her intestine that cannot be fixed and that it is not helpful to consider other feeding options.

This is a really hard concept to get one's mind around. Food is the center of life. It is how we show our caring of other people. it is how we reward ourselves and others and  and how we celebrate life. So to not be able to eat really brings home the terminal nature of your mother's condition.

You ask how long your mother can continue without nutrition. If she does not have any other major medical conditions such as kidney or lung problems, with hydration, she can be present with you for a few weeks and even up to a month. If she has other serious health problems, her time may be much shorter.

Hospice can be a very important part of care at this time. If your mother has not been set up with this group, you should ask her doctor about a referral.
take care

[MLWTR]

I'm very sorry to hear about your mother. I'm wondering whether there aren't other nutritional options so that she could feel more comfortable (assuming that the doctor feels that more food would be beneficial to her). Most absorption of food takes place in the small intestine, so even if she has some sort of problem with her stomach, it's hard to understand why she wouldn't absorb the nutrients from tube feeding. You can also bypass the stomach entirely, and use a nasojejunal or nasoduodenal tube (feeding tubes that go directly to the small intestine).

Now perhaps there was a miscommunication, and the problem is actually not the stomach but rather issues with small intestinal absorption, which I presume could occur if the cancer has involved the small bowel. Then it might take TPN in addition to tube feeding to keep her adequately fed.

Anyhow, I'm sure you'll have a response from the forum doctor soon that will help sort things out. I'm not an MD, just a medical writer who has some knowledge of tube feeding from writing about G.I. issues; I just wanted to mention the other tube feeding options in case that might be of any use to you.

[Sacto Mom]

Thanks to both of you for your comments. This is a difficult time but it is eased by the absolute peacefulness and calm with which my mother is approaching the end of her life - a life that has given her great joy and satisfaction.

Yes the blockage is in the small intestine - the surgeon reported "only a trickle" of contrast went from the stomach into the intestine and her overall health did not make her a good candidate for surgery. She had already had bowel obstruction surgery two years ago and lived far longer than her doctors predicted at the time.

I appreciate the helpfulness - she was discharged to home today and we expect Hospice to begin care soon.

Thank you again for your thoughtful, caring responses. It means a tremendous amount to me.