Stage 4 Liver Cancer and All Treatment Options Have Been Exhausted. What's Next?

Kellyv asked...

doctor said "to ride it out", whats next

Expert Answer

Bonnie Bajorek Daneker is author and creator of the The Compassionate Caregiver's Series, which includes "The Compassionate Caregiver's Guide to Caring for Someone with Cancer," "The Journey of Grief," "Handbook on Hospice and Palliative Care," and other titles on cancer diagnosis and end of life. She speaks regularly at cancer research and support functions, including PANCAN and Cancer Survivor's Network. She is a former member of the Executive Committee of the CSN at St. Joseph's Hospital of Atlanta and the Georgia Chapter of the Lymphoma Research Foundation.

Hi Kelly, It's difficult to know what the doctor meant exactly by "ride it out," but likely it means that no further options for treatment of the cancer remain. At this time, your role as a caregiver will change from active treatment to comfort care. The focus will shift to quality of life issues, like pain, nausea and anxiety. Work with your treatment team on these issues to give the patient as much comfort as possible. If you haven't had a discussion about end of life issues, including referral to hospice when you and the treatment team think it's appropriate, now is the time to do that. Make sure your patient's affairs are in order, like a living will and power of attorney, as well as advance directives. You will need to get more information from the hospice team on what you can expect as your patient progresses toward the end of life. You can begin to watch for changes in his physical and mental states, including changes in breathing, skin color, and thought processes to let you know this is happening -- don't be alarmed if you see these, it's part of the natural process of dying. The hospice team will guide you on the specific happenings with your patient, and can advise you on how to best help him. You may also find some comfort in Elizabeth Kubler-Ross's book "On Death and Dying." My thoughts are with you, BBD