What happens from here

[Lacey157]

Hello,  I have written to you before and I thank you for your advice. Just a recap, my mom is an eight year survivor of ovca and she has had multiple recurrences.  The recent recurrence was in Dec of 2007 and her oncologist with the use of chemo has kept it at bay.  She started Topotecan in February, 3 weeks on 1 week off, she got two of the treatments in and then she went into the hospital on Feb 17 with a bowel obstruction caused by a tumor.  the oncologist told us that she would keep getting these until one of them eventually would take her.  She also got an infection in the blood they gave her IV antibiotics while in the hospital and then when she came home she was given oral antibiotics.  She was a very active women prior to the bowel obstruction, now her performance status is a 3/4. Will she ever get the strength back again, have you seen it happen.  I have looked up bowel obstruction with ovca on the internet and the prognosis is not good.  I believe she is getting another one she didn't have a bowel movement for 3 days and now has diarrhea so bad she has to wear a depends because she can't make it to the restroom in time.  She is restarting the chemo on Tuesday is this a good idea?  They say that her lab values are ok to get the chemo.  Is this the quality of life she is going to have here on out.  Her last CT scan showed that there is nothing in her abdomen that doesn't have cancer on it.  She also has acites which put her in the ER and the doctor stated it was the fluid in her abdomen pushing against her lungs making it hard for her to breathe, they did not drain it is this normal?    Is the acites caused by the liver not functioning properly? The oncologist won't tell us anything because my mom does not want us to know, he can only tell us what she will allow and he can only speak to us while she is present. what is your prognosis?  I am just concerned and stressed not knowing what is happening and what to expect.  Thank you for your time.  
Lacey

[Annekathryn Goodman, M.D.]

Dear Lacey,
I am so sorry for my delay. I really got clobbered by my day (well day/night) job this month.  I am far, far behind in my answers and finally am able to respond.

I am so sorry to hear about your mother. What a heart break!!
You are now shifting into a different phase of struggle around your mother's illness.
I am glad the her oncologist has spent some time talking to you and your family.  I wonder if that is a bit of a relief, just to understand that there are so many parts of this disease that are out of our control. I think many family members and many women who are experiencing ovarian cancer feel a tremendous guilt at not trying one more chemo, that maybe this next chemo might give them more time.

But at some point, the body just does not work anymore. A bowel obstruction can be one of those times. A serious blood infection is another. And organ system failure such as kidney or liver failure prevent the ability to give more chemo.

Anyway, I hope that you have good supports with the hospice team. The changes around dying can be scary and it is good to have someone there who can tell you that it is normal and to know how to help alleviate suffering.
best wishes

[Lacey157]

Another update: On March 10th mom went to get chemo and the oncologist sat down with her and my dad and told them that she still has a partial blockage and that there is no more that he can do for her and now she is at home with hospice the oncologist gave her 3 weeks to 3 months she is getting around the house pretty good, she doesn't go outside the home though she is to weak for that.  Her abdomen is huge it is now starting to push against her lungs, it is hard for her to breathe and when she she is sleeping she sounds like a howling dog it is very agonizing to hear.  She continues on the Norco she is to stubborn to start the morophine, they are sending a new pain med though, it is givin in shot form I am unsure of what it is at this time. Her skin color is darker not a yellow color yet just darker like she was out tanning, not sure what that is either.  
Thank you for all your time and advice
Lacey