Husband died of Lung cancer or Septic Shock? - 1255706

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

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

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

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.

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-liq…

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

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

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#msg90… 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

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

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