1. < Colorectal Cancer

What ultimately causes death in metastatic colorectal cancer (MCRC)?

Posted by chuckmii @chuckmii, Dec 19, 2023

I know this may be a morbid topic but after my wife's latest blood work I am cautiously optimistic in how the cancer is/not progressing. She spent 5 weeks in the hospital after an obstruction and emergency surgery and colostomy. She has been home for a month now and we just got labs done and CEA only went up 11 points from 111 to 122. In the hospital surgeon said there was little to no change in her tumors and the oncologist called it mixed results. This is now 2 months after her last round of chemo.

There are some concerning things in her bloodwork, still very anemic, iron levels extremely low (they want us to go for another round of iron infusions (you go every other day for 5 visits) and things like red blood cell distributions and other indicators that look like her body is not getting enough oxygen flow and just not normal.

Now to my question, is it more likely that the spreading cancer causes something else in the body to shut down/go wrong which ultimately causes death? What should I/we be looking out for?

It is currently in her colon, liver and peritoneum (which has a large cyst around it) and adrenal glands.

Interested in more discussions like this? Go to the Colorectal Cancer Support Group.

rjjacobsen | @rjjacobsen | Dec 20, 2023

Chuck - I can't answer your question, but am just posting to let you know that I'm praying for you and your wife. God's blessings on you both!

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Moderator
Colleen Young, Connect Director | @colleenyoung | Dec 21, 2023

@chuckmii, there is actually research looking into this very question.
- Cause of death among patients with colorectal cancer: a population-based study in the United States https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746372/
"Among all CRC patients included in this study, a total of 531,507 deaths were recorded, of which 51.3% were due to CRC, 10.3% were due to other cancers, and 38.4% were due to non-cancer causes."

Reading between the lines of your question, I think you may also be inquiring about what to expect. I found this article from Virtual Hospice helpful:
– Final weeks and days: What to expect https://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Final+Days/Final+weeks+and+days_+What+to+expect.aspx

It helped me to prepare when my dad was diagnosed with stage 4 colon cancer and he chose to stop treatment. He also had a minor cardiac defect and type 2 diabetes. His organs simply started to get weaker and he died at home. My father-in-law had metastatic prostate cancer and again we were better prepared as to what to expect. He had home hospice and we set up a hospital bed on the main floor so he could have a clear view through the picture window to the lake – the view for which he built the house.

Have you looked into palliative care and/or hospice options for when they are needed?

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chuckmii | @chuckmii | Dec 21, 2023

@colleenyoung Thank you for the reply and the links. She does speak to palliative doctors every few weeks and they did speak with me when she was in the hospital, trying to prepare me for it getting worse and needing to increase pain meds, etc when that happens. She has been in denial about this being non-curable but is starting to come to that realization. The surgeon call today shocked her, he signed off and said, any remaining bloating and discomfort is due to the cancer (which he saw) and I am turning you over to oncology. Not sure what she was expecting but that wasn’t it. She has been crying and now realizes the chemo is all she has left to fight this and based on the previous results and the fact that we are going to remove the oxiliplatin due to the side effects, it may not do much. She feels like we are back to where we started 5 months ago but is worse off due to everything that has happened to her body. Of course she wouldn’t be here at all right now if it wasn’t for the surgery but the infection and complications were hell for her. Add to all this the cancer drug shortages and you have to wonder how we all get through any of this.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Dec 21, 2023
In reply to @chuckmii "@colleenyoung Thank you for the reply and the links. She does speak to palliative doctors every..." + (show)
@chuckmii

@colleenyoung Thank you for the reply and the links. She does speak to palliative doctors every few weeks and they did speak with me when she was in the hospital, trying to prepare me for it getting worse and needing to increase pain meds, etc when that happens. She has been in denial about this being non-curable but is starting to come to that realization. The surgeon call today shocked her, he signed off and said, any remaining bloating and discomfort is due to the cancer (which he saw) and I am turning you over to oncology. Not sure what she was expecting but that wasn’t it. She has been crying and now realizes the chemo is all she has left to fight this and based on the previous results and the fact that we are going to remove the oxiliplatin due to the side effects, it may not do much. She feels like we are back to where we started 5 months ago but is worse off due to everything that has happened to her body. Of course she wouldn’t be here at all right now if it wasn’t for the surgery but the infection and complications were hell for her. Add to all this the cancer drug shortages and you have to wonder how we all get through any of this.

Jump to this post

Denial and acceptance are a part of the journey. Not easy.

At the risk of overloading you, I have some more links that were helpful for me and my family.
Again from Virtual Hospice:
- Hope and Denial https://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Emotional+Health/Hope+and+Denial.aspx

There are professional supports out there for YOU and for your wife if and when you should need them like social work and chaplain services. Hospice volunteers are amazing too.

– How an Oncology Social Worker Can Help https://connect.mayoclinic.org/blog/cancer-education-center/newsfeed-post/how-an-oncology-social-worker-can-help/

There are social workers specializing in oncology and in palliative care.

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