My mother in law was diagnosed with small cell lung cancer in early January. It had already spread to her liver, pancreas, and bone. She completed her fourth round of chemo in April, and some of the tumors did shrink. But her dr. says no more chemo, she is too frail to withstand any more. She has had to have blood transfusions twice, she shakes uncontrollably all the time...dr. thinks it is anxiety that is causing her to shake. I disagree. She is always tired and takes naps several times a day. She has zero energy, and can't walk without a walker now. (She is 71) Before the cancer, she was so energetic. It's hard to watch her deteriorate. She does have pain from the bone metastases, but it is controlled with a pain patch for now. It is in her skull bone and her left femur as of the last CT scan...My question is, since she cannot have any more chemo, and further treatment will only be palliative, how fast will things go downhill? She already seems to be getting worse since the chemo is clearing from her system. What can we expect now that more chemo is no longer an option? Thanks.