What to expect end of life pancreatic cancer metastized to liver?

Posted by lbern @lbern, Mar 3, 2019

Wondering if someone with experience with end of life patients with significant liver involvement can please comment on what I can expect as disease progresses, My doctor says it’s so varied he can’t say. I’ve heard through the grapevine that ammonia builds up causing delirium or that one sleeps for weeks. I would like to know how typical either of these are, as well as what other things happen. How can delirious patients be treated if at home? How long can that last? What about eating /drinking? Do we basically starve to death? I realize there are people who might not want to know this, but not knowing likely possibilities is causing me more anxiety than I think knowing would.

These are questions people want answers to. Many doctors have a hard time trying to help us find answers, in part, because every patient and circumstance is so different, but also because many doctors find it difficult to talk about death.

Helping me to prepare for my father's death, I found these articles from Virtual Hospice to be comforting and practical:
– When death is near http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Final+Days/When+Death+is+Near.aspx
This article includes information decreased food and fluids as well as confusion, agitation, and “visions”.

– Confusion http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Symptoms+_+Health+Concerns/Confusion.aspx
– Lack of Appetite and Loss of Weight http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Symptoms+_+Health+Concerns/Lack+of+Appetite+and+Loss+of+Weight.aspx
– What can be expected with liver metastasis? http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Support/Support/Asked+and+Answered/What+to+Expect+with+Various+Illnesses/Cancer/What+can+be+expected+with+liver+metastasis_.aspx

@lbern, Have you considered talking with a palliative care clinician?

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@lbern, I also want to invite you to take part in this discussion on Connect:
– Talking Frankly about Living with Advanced Cancer https://connect.mayoclinic.org/discussion/talking-frankly-about-living-with-advanced-cancer/

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Hello @lbern I am Scott and while my wife had a different type of cancer I can at least relate what I witnessed as her caregiver. She made the decision for home hospice, which we were thankfully able to accomplish, but was a challenging path at times..

My wife's hospice nurses gave me a variety of booklets they had on end of life and what to expect. While I read each of them my wife chose to not read any of them. It was her belief that the best thing for her in her journey was to just stay in touch with her body and to fight and react based on how she felt each day. That was probably a very good decision by her since none of the 'paths' described in the materials we were given matched what she went on to experience.

Her neuro-oncologist was our best advisor when he told us each patient is unique, each cancer is unique, and each journey is different.

Have you sought out any materials from a local hospice in your area? Or perhaps a local doctor who specializes in palliative care?

Strength, courage, and peace!

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Hello @lbern

I just read Scott's (@IndianaScott) reply and I think that a visit with a Palliative Care Specialist might be a very good idea. As you may know, palliative care is different than Hospice care and can be quite helpful when you are dealing with a chronic/serious illnesses. Here is some information about palliative care at Mayo, https://www.mayoclinic.org/tests-procedures/palliative-care/care-at-mayo-clinic/pcc-20384639

If you do not live near a Mayo facility, (Minnesota, Florida, or Arizona) you might check with your doctor and see who would specialize in palliative care in your vicinity.

Will you post again and keep in touch?

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