Husband died of Lung cancer or Septic Shock?

Portal Forums Cancer Treatments / Symptom Management Patient Experiences Husband died of Lung cancer or Septic Shock?

This topic contains 13 replies, has 5 voices, and was last updated by  love4t 4 years, 7 months ago.

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April 16, 2013 at 5:32 pm  #1255706    

love4t

On Jan 26, 2013 My 46 year old husband drove himself to and walked into the ER after having congestion and a bad cough for over 3 weeks. Xray and Cat scan showed a large mass in his chest and neck, admitted, biopsy revealed adenocarcinoma probable origin from the lung, port was put in for chemo and plans to discharge with plans for outpatient radiation and chemo. 7 days after being admitted was told he had a blood infection from his port and hospital acquired pneumonia but they acted like it was routine and started AB. He started swelling, blot clots, fast pulse, low BP, trouble breathing etc. 1st round of chemo done Feb 2. Feb 7 started hallucinating, pulling lines out, trying to leave hospital and was found by the elevator on another floor, 2 hours later he had to be intubated (doctor said tumor had wrapped around his trachea). He received another round of chemo while on life support and his body started swelling severely (gained over 50 lbs in a couple weeks),everything started failing except his brain. I was harassed to take him off the ventilator but refused, he was moved to another (better) hospital and was on dozens of meds, he lived till March 11 (4 weeks and 4 days on life support) Found out after his death he had septic shock and 2 port infections and pneumonia all acquired from the 1st hospital. I got and am reading all his records from the 1st hospital (over 2500 pages) and am finding that all his problems seem to be from sepsis infection and not cancer. There was alot “swept under the rug” and I can’t help but to want to know why. I wondered why the doctor’s at the first hospital kept insisting to “terminally wean” him off the ventilator even though he could communicate with his eyes. They kept claiming the cancer was the culprit. I don’t even know if he even had a chance to fight the cancer. My husband was a hard working man, he was doing yard work a week before going to the ER. Is it just me or does something just not seem right with this?

April 16, 2013 at 7:33 pm  #1255709    
JimC Forum Moderator
JimC Forum Moderator

Words cannot express how sorry I am to hear of what happened to your husband. It is always difficult to find answers to the questions you ask – How could this happen so quickly? Was something done wrong?. I spent a great deal of time second guessing my wife’s treatment decisions, even though I had total faith in her oncologist; it’s just that when you get to a certain point, there is no manual and you need to use your best judgment on how to proceed. From a medical point of view, at the very least it would require a medical professional (or perhaps several) reviewing all of his records to try to determine exactly what happened, and even that might prove inconclusive. From your description of his symptoms and the xray and CT findings, as well as the later finding that the tumor had wrapped around his trachea, it seems that your husband’s cancer was advanced and that very likely his immune system was severely compromised. Once that has happened, he becomes more susceptible to infection and pneumonia, which can lead to septic shock and other problems, and the addition of chemo (which also compromises the immune system) can only make matters worse. And yet your husband most likely needed chemo to try to shrink his large tumor. It can simply be a question of a weakened immune system being unable to fight off things that a stronger system would be able to resist, and at the same time not being able to tolerate the kind of potent treatment needed to fight an aggressive cancer.

I realize that none of this provides you with an answer to what happened and why. No one here, without access to all of his records, would be able to say what occurred or whether something was done improperly. But cancer weakens the body in so many ways that it can be impossible to prevent the secondary problems it causes, and that may be what happened in his case.

Please accept my sincere condolences. My thoughts will be with you and your family for peace and comfort.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

April 16, 2013 at 7:49 pm  #1255710    

marisa93

I want to offer you my heartfelt condolences. What a shock you’ve had in losing your husband so young and under such circumstances. My husband fought his cancer for a year and when he passed I couldn’t help but wonder what had gone wrong. What else could we have done or what might have been missed? It sounds like your husband’s cancer was very advanced and things went wrong very quickly before you had a chance to really get your mind around what was taking place. That is what cancer does. When it decides to go bad it does so very quickly. I hope you have people around you for support and wish you the best in healing from your grief.

Take care,
Lisa


Nov 23, 2010 husband(49/smoker) dx IV NSLC mets to brain/liver, Nov-Dec, 2010 15 WBR tx, Jan’11 MRI much improved, Dec ’10-Mar’11 4 txs carbo/alimta/avastin w/good response, Apr ’11 MRI mets almost gone, Apr ’11 start maintenance alimta, Jul ’11 MRI still good, Jul ’11 carbo/taxol for new lung met and 2 liver mets, Oct ’11 MRI new brain mets and major progression in liver, Nov 2, ’11 GK, Nov 19, 2011 at peace
Since then: http://cancergrace.org/forums/index.php?topic=11426.0

April 17, 2013 at 12:39 am  #1255720    
Dr West
Dr West

I, too, am very saddened to hear of this course of events. As Jim noted, we couldn’t provide any insight, and it would be inappropriate for any of the faculty here to just speculate without having all of the relevant details.

Please accept my sincere condolences.

-Dr. West

April 17, 2013 at 1:34 am  #1255722    

certain spring

What everyone has said is absolutely right, though not much consolation for your traumatic experience and awful loss, love4t.
I think part of the problem is that we tend to have a model of cancer as being a slow decline, whereas lung cancer can kill very fast. I nearly died of pneumonia a week after I was taking seminars with students. As Jim says, chemo puts a person at risk because it clobbers the immune system as well as everything else. So your question “was it lung cancer or septic shock?” is kind of a false choice. Lung cancer creates an environment in which sudden, fatal events are a real possibility, even in someone who seems fine. Septic shock would be one example, a blood clot (pulmonary embolism) would be another.
It seems to me that your underlying question is “Was the first hospital at fault”? and that’s presumably why you are going through the records. It’s a reasonable question, but it sounds as though it would be hard to prove, especially as your husband’s cancer was already quite advanced when it was diagnosed. I am not surprised you are angry and upset – I would be too in such circumstances. Hospitals do make mistakes, and if you don’t like the way your husband was treated you should complain. But again, it’s a false choice – even if his treatment and care had been perfect in every way, he might still have died as quickly as he did. Very difficult to accept but as Lisa says, “That is what cancer does”. Best wishes to you and your family.


49-year-old non-smoker, dx stage IV NSCLC May 2010 (squamous tumour of the left lung with multiple brain metastases). Radiotherapy to chest and brain; progressed through two cycles carbo/gemcitabine. Repeated lung collapses; pneumonia in collapsed lung, Nov 2010; bronchial stent placed, Dec 2010. Declined second-line Taxotere. Mutation testing Feb 2011, surprise EGFR exon deletion 19. Started Tarceva (150mg), Feb 2011. Progression in liver and elsewhere, May 2013.

April 17, 2013 at 7:22 am  #1255725    

love4t

Thank You all for your condolances. I guess my question(s) should be more cut and dry. I would like to say my husband had a wonderful oncologist who was not on staff at the hospital. He never once gave up on my husband, he was a blessing to me and my husband and always had hope. To my questions. In general, is a tumor liquid or solid? How fast do typical adenocarcinoma tumors grow as compared to say inflammation? Doesn’t chemo typically cause WBC count to decrease? For example a WBC count of say 17.5 before any chemo ever given and a WBC count of 21.4 two days after 1st round of chemo. Would that scenario be typical?
To certain spring: I am finding that my husband had sepsis before any chemo was ever given and I understand cancer creates an environment for fatal events to occur but the fatal event of septic shock is not possible without the presence of bacteria (or rarely fungal) being introduced into the system by some means. I see where it seems the underlying question is “was the hospital at fault” but right now I am at “was a bacterial infection (irregardless of where it came from at this point) at fault”
I guess I’m feeling the what if’s and am finding that while cancer is bad, blood infections can be as devastating, even healthy people get sepsis but it begins with an infection. I had never heard of this condition before but am finding that it is has a high rate of morbibity and is up there in # of deaths occuring from it. It is potentially fatal and preventable. I am beginning to realize the importance of infection control in the healthcare industry. Thank You all for your responses, I appreciate them all.

April 17, 2013 at 7:58 am  #1255728    
JimC Forum Moderator
JimC Forum Moderator

love4t,

To address your specific questions, lung cancer is a solid tumor. You can read a discussion of solid vs. liquid tumors here: http://www.nccn.com/component/content/article/54-cancer-basics/1042-liquid-versus-solid-tumors.html

Adenocarcinomas can grow slowly or very quickly. Given the fact that shortly after diagnosis your husband’s tumor wrapped around his trachea, I would assume his tumor was growing quickly. Chemo certainly decrease blood counts, and it can vary based on the drug and the patient. But the counts don’t decrease immediately but rather over the course of a number of days, usually about half of a chemo cycle, the idea being that in the first half of the cycle they will decrease then bounce back in time for the next treatment. But with everything else that was going on with your husband’s health, the chemo wasn’t the only factor influencing his blood counts.

I can understand your need to understand and explain what happened, and of course infection control in healthcare is critical. On the other hand I don’t think it’s possible to determine the source of the infection or to determine whether even the best hospital practices could have prevented it. In a way it’s similar to my wanting to know how my wife got lung cancer…neither she nor I ever smoked and our house did not have a radon problem, but there were many other potential causes. At some point I had to accept that I would never know what caused it, and whether there was something we could have done to prevent it.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

April 17, 2013 at 9:02 am  #1255730    

love4t

Thank You so much for your response and the link to the site, it was very informative. The material submitted for biopsy done on my husband’s neck tumor (they call it a mass, if there is a difference) was ” clear fluid without visible tissue”. I do need to note that the doctors assumed the “tumor” wrapped around his trachea, a CT scan was not done to show that a fact, beings that the rest of his body was experiencing extensive edema, I think it would be safe to say that the neck area would also swell possibly causing an airway problem. Interesting about the WBC count. It seems that the only time his WBC counts were not excessively high and within normal limits were in the range of time when the chemo would affect the count the most and thereafter. His WBC count never dropped below the normal range.
My condolences to you and everyone else who has battled cancer, sepsis and any other condition alongside their loved one, for we have taken on suffering and pain as our loved experienced it. They have left their condition behind and I guess in time those of us who remain, do, one day close the book on the condition also…or do we?

April 17, 2013 at 5:43 pm  #1255740    
Dr West
Dr West

I can’t say whether the biopsy just failed to sample the area that would have shown lung cancer, but that can happen. As for the question of the rate of progression of an adenocarcinoma, it can be anything from very indolent to very aggressive, but in addition, if it’s growing in a way that closes off an airway, it can lead to a quick decline in a very short time, even without a major amount of growth, just by crossing a threshold. One of the things we learn with experience in managing cancer is that it can do just about anything: grow very quickly, grow very slowly, grow anywhere, cause any kind of complication. That’s humbling and not satisfying, but it’s true.

As for the WBC, that can be affected by many variables, so it’s not possible to draw any firm conclusions about what to expect in such a complex situation, especially just a few days after chemo was given.

-Dr. West

April 17, 2013 at 6:45 pm  #1255746    

love4t

Thank you Dr. West for your explanations. I guess I am just going through the what if’s. I was really caught off guard when a few days after my husband passed, I was told that septic shock was a contributor to his cause of death. When all along I thought all complications were cancer. I guess I’m just feeling like the first hospital “pulled the wool over my eyes”. They didn’t even inform UF Gainesville that he was septic, they accepted him to perform a procedure and placed stents in his airway and right bronchi. We were hopeful that the stents would make it possible to come off the ventilator so he could speak being a trach was impossible, he had the endo tube in for over 4 weeks (way over the recommended time) UF tried everything to save my husbands life and I appreciate their effort. I wish that somehow his death could possibly help someone somehow, if somehow something could be learned from this. My husband always had a soft spot for cancer research. Do you know if there’s such a place where research is done just off of medical records, labs, biopsy sample etc.?

April 17, 2013 at 7:29 pm  #1255749    
JimC Forum Moderator
JimC Forum Moderator

love4t,

I don’t know that we close the book on the condition, but at some point we find a way to put it into a larger perspective and think less about the process of our loss and more about our good memories of our loved one.

I think it can be helpful to have someone to talk to about what you’re thinking and feeling, preferably someone who has suffered a similar loss and can understand. Having each lost our long-time spouses to lung cancer within a two week period, Lisa and I were fortunate enough to begin a dialogue here on GRACE which helped both of us deal with our losses. You can read the beginning of that dialogue here: http://cancergrace.org/forums/index.php/topic,10983.msg90743.html#msg90743 In one of my posts in that thread, I shared this wise quote from GRACE’s late member Simon54, whose grace in facing his own battle with lung cancer enriched the lives of all he touched here and whose absence we still lament:

“I think so much about how my wife, and other loved ones, will handle my death when it comes. She is not well able to talk about it now, perhaps she will never be with me, I don’t yet know. Whatever may be my grief now, it comes to an end then, whilst perhaps it is only then that her grief will truly break out. I need to believe that as she lives on she will find happiness again, and will remember me in love. I hope still to be a part of that happiness ahead of her, not just as ‘memory’, but also because I believe people change one another through love.” – http://cancergrace.org/forums/index.php?topic=10983.msg91058#msg91058

I am certain that the love you shared with your husband has changed you and lives on within you.

Continued wishes for peace and comfort,

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

April 17, 2013 at 7:50 pm  #1255754    
Dr West
Dr West

love4t,

I appreciate the sentiment of what you want to do. Practically speaking, I don’t think there’s a mechanism to use his records for research in that way.

I think Jim’s words and those of other people here will be the most helpful way to work through what you’re facing. You’re not alone: many people can relate very directly to what you’re experiencing now.

-Dr. West

April 17, 2013 at 9:35 pm  #1255761    

marisa93

Love4t,

I am so sorry for what you are going through. I know what a difficult time this must be for you. When my husband passed away it was a shock as he seemed to be doing quite well. Things went bad very quickly and after he passed I began searching for answers. I thought there had to have been something that was missed(I picked up his last scans to scour over), more that could have been done. I just felt as though it shouldn’t have happened when it happened, how it happened, etc. It took time but I began to realize that my searching for answers was not going to change anything and was only delaying my acceptance of the loss of my husband and ultimately hindering my healing from grief. I hope you can find peace and comfort in the days ahead from memories of your husband and the life and love you shared.

Take care,
Lisa


Nov 23, 2010 husband(49/smoker) dx IV NSLC mets to brain/liver, Nov-Dec, 2010 15 WBR tx, Jan’11 MRI much improved, Dec ’10-Mar’11 4 txs carbo/alimta/avastin w/good response, Apr ’11 MRI mets almost gone, Apr ’11 start maintenance alimta, Jul ’11 MRI still good, Jul ’11 carbo/taxol for new lung met and 2 liver mets, Oct ’11 MRI new brain mets and major progression in liver, Nov 2, ’11 GK, Nov 19, 2011 at peace
Since then: http://cancergrace.org/forums/index.php?topic=11426.0

April 19, 2013 at 6:26 pm  #1255803    

love4t

Trust me I have accepted the fact that he is physically gone, I had to see him swell up and become unrecognizable. I saw him after he passed and had to bury him and I know that nothing I do or find out will bring him back. Every situation is different and everyone mourns differently. I happen to find a little comfort going over his records cause obviously I was not told many things and now I know what was going on. I am seeing that many of those diagnosed with lung cancer have a little time from diagnosis. My husband was septic after 1 week in the hospital, they had the discharge papers in the works and appointments set for outpatient treatment, then bam, overnight, total decline. I didn’t know of the septic shock till it appeared on his DC, then to find out he had it since the week after admission, then to find out that he got it from 3 nurses who tried to reinsert his dislodged port in his room under unsterile conditions. I am finding that others on this page had time to spend with their loved one or have time themselves now, what if you didn’t have that. Trust me, your loved one (or yourself) would have gone quickly if they’d have become septic and you wouldn’t have had time with them. My husband wanted more than anything to go home, even if for 1 day. You are fortunate to have had that.
And by the way, make sure no one touches or performs any kind of procedure on you or your loved one until you see them wash their hands and are palm up gloved and insist on it. And in all due respect, any doctors and nurses out there, please do your patient a favor and get rid of any bacteria that you may have linguring on you, there’s a reason infection control is taught in med/nursing school, people come to the hospital for a certain condition and don’t need the added complication of a bacterial infection. I am bringing this to light because this is what happened to my husband, he suffered from this in addition to the cancer, it is his story.

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