Does this signify last stages of life? - 1249077

lovingson
Posts:5

Hello to all at Cancer Grace. My dad has been using oxygen (level 4) for the past few days 24/7. Today he was taken to emerg to because he simply couldn't breathe last night. His oxygen levels were in the low 80s, high heart rate and low blood pressure. With oxygen now (level 15) his O2 levels are in the low 90s. He had a CT scan mid September which showed minimal progression from previous scan so the Drs suspect pneumonia or infection and have started him on antibiotics. Can pneumonia dramatically reduce O2 levels as such, and if he only marginally improves from antibiotics will he be able to even try Tarceva as second line therapy. Considering the disease, his age and the fact he has some pulmunary fibrosis, can his breathing improve? It seems to me that this is a very serious situation for him to be in and that it may be too overwhelming for his body to recover. He was eating quite well previous to this and seemed on track to receive Tarceva (a good second line therapy even for Squamous as I have read here). I appreciate any feedback and thank you.

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Reply # - October 15, 2012, 06:21 PM

JimC
Posts: 2753

I'm sorry to hear about your dad's oxygen problems. It sounds like his doctors do not see this as a direct cause of his cancer, since the recent scan showed only minimal progression, apparently nothing that would seem to cause such severe breathing problems. Suspecting pneumonia or an infection seems reasonable, and hopefully antibiotics will help with that.

How well (or whether) a patient can tolerate chemo or a targeted agent such as Tarceva is always dependent on the overall health of a patient, so his doctors will most likely want his situation to improve before they would consider starting Tarceva.Without knowing everything about his condition, it would be impossible for the doctors here to know what is causing his oxygen problems, and whether it might signify the approach of end of life. But as far as his cancer is concerned, what you've said about the minimal progression on his last scan would not seem to indicate that.

JimC
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Reply # - October 15, 2012, 09:47 PM

Dr West
Posts: 4735

It sounds to me as if there's a real chance he'll improve meaningfully, and potentially to a point where further therapy could be considered. If his doctors think much of what's happening is reversible, that's encouraging, though I'm sure neither they nor we could provide any assurances that things will turn around. There are often may potential causes for a drop in the ability of the lungs to oxygenate blood well, and sometimes several things may be happening at once. Often, we try to treat everything that is reversible and then wait to see how well things improve.

Good luck.

-Dr. West

Reply # - October 17, 2012, 12:13 PM

lovingson
Posts: 5

Thank you both Jim and Dr West. He continues relying on O2 at the moment and started antibiotics to help with the pneumonia. I understand that pneumonia is a very serious infection for someone in his situation. I guess now it is a waiting game for the next few days to see if there is any improvement. Just wondering how soon or long can it take to see marginal improvement with such an infection? Does it mean that if there is no improvement with a couple of days, it may not improve at all or could the process take longer?

As always I appreciate the valued opinions and information from cancer grace. This website has provided a plethora of information and has helped educate us throughout our battle with lung cancer. We appreciate it immensely.

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