Stage 4 lung cancer....?!

Honey, I am really sorry this is happening to you. Nobody wants to contemplate the end of life for someone they love. Sometimes reality bites so hard it hurts. Your grandpa likely knows he is going to die soon and has chosen not to fight it. He will not be in any pain. The palliative care staff will see to that. He will get weaker and start to sleep a lot. He will not have much of an appetite as he will not need much energy. Eventually his body will start shutting down.

Physical changes in dying

Although no two people experience illness in the same way, some generalizations can be made about how an illness begins to weaken the body when a person is nearing death. Over time, most health conditions affect vital systems of the body, such as the brain and nervous system, lungs, heart and blood vessels, or the digestive system, including the liver and bowels.

As illness progresses, there is a point at which the body is not able to use the nutrients in food, resulting in weight loss and fatigue. More time is spent resting, and in the final few days before death, people are generally sleeping most of the time. The body’s various systems gradually weaken and shut down.

At the end of illness, the cause of death is generally due to one or more of the following.



* Specific complication of the illness
This could be the heart stopping in people with advanced heart disease, or the kidneys failing in people who have kidney disease.


* Accumulation of total burden of disease
People experience a profound depletion of strength and energy, sleeping most or all of the time as the body’s systems shut down. Death eventually occurs when the heart stops because it cannot function when the other organs of the body are shutting down.


* Infection
In the final hours, when the person is deeply sleeping and not aware of their surroundings, an infection in the lungs (pneumonia) usually develops due to an inability to cough and clear the secretions that the lungs normally produce. This infection does not respond to antibiotics, due to overall frailty and a weakened immune system.

Progression of changes

When a person is nearing death, there are a series of signs that signal when the body is in the process of shutting down. These signals are presented in the following sections, in the order in which they tend to appear.

Please note that when death is expected within hours or days, the focus of care is usually geared toward maintaining the person’s comfort rather than pursuing tests and treatments. Also at this time, families may want to consider whether there are important cultural, spiritual or religious rituals that need to take place just prior to death or at the time of death. If so, it is helpful to inform those who will be participating and link with the health care team as required.
Declining physical capabilities

In the final few weeks of life in progressive serious illness, there is usually a notable decrease in energy and day-to-day functioning. A very significant change is when the person is no longer strong enough to be out of bed. When this is caused by overall weakness from the total disease burden rather than from a specific, possibly fixable problem, it may signal that there are only days to a few weeks to live.

The illness may appear to "speed up", as weakness quickly leads to even further weakness. This decline is often most striking in the last few days of life, when people can change from being fairly independent to sleeping all of the time.

In order to understand why things seems to change so quickly near the end, think of the energy that gets us through the day as being similar to money in the bank. When we are physically well, we can build up our energy savings by eating well, keeping fit, and making other important health and lifestyle choices. When a progressive serious illness occurs, it interferes with the body’s ability to add to the reserves of energy. This is not unlike losing the ability to earn income to add to bank savings.

In such circumstances, we must use existing savings to get through each day. When the body’s energy reserves (savings) are nearly gone, there are dramatic changes in how a person appears. People spend more time sleeping, and less time in activities. When the energy runs out, there seems to be a sudden, big change. The person has no energy to be awake, to communicate, or to take in food or fluids. This change usually signals the final hours or perhaps days of life.

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One of the ominous complications of advanced lung cancer is [post obstructive pneumonia] which is pneumonia occurring distally to bronchial obstruction by tumor cells ,very hard to cure as antibiotics may not be enough to get red of it .
I hope he doesn`t have the post obstructive type otherwise the short term prognosis is extremely poor .
Stage 4 lung cancer is terminal illness and you need pass the denial phase ,sorry to deliver bad news .

I am physician

You can expect to have to face reality whether you like it or not.
His cancer is not curable and treatment at this point is to keep him as comfortable as possible,.
I’m sorry.

I am a cancer registrar.

I'd say anytime an elderly person comes down with pneumonia its pretty serious, but the fact that your step-grandpa also has lung cancer undoubtedly makes the situation even worse I'm afraid.