How much time does Mom have?

A fellow caregiver asked...

My mother-in-law was diagnosed with a brain tumor (GlioBlastoma Multiforme) in February, we have been through radiation and chemo, following the radiation cycle we had another MRI done and discovered the tumor was indeed larger and had spread. Her condition has deteriorated progressively. She has been unable to swallow for some time now and we have been feeding her via a nasal tube exclusively for about 6 weeks now. We have been told that as she nears the end of her life we will have residual nutritional supplement between feedings due to her organs beginning to shut down. Once we confirm there is a residual issue what sort of time frame should we expect? Weeks? Days? Her doctor gave a prognosis of "weeks to a couple of months" at her last visit in June.

Expert Answer

Linda Ackerman, R.N. has clinical experience in oncology, women's health, and medical nursing. She has been practicing for more than 20 years and is a licensed registered nurse in both Florida and Wisconsin. In addition, she serves as a board member of Breast Cancer Recovery and the Wisconsin Cancer Council.

Glioblastoma is well documented as a very aggressive type of cancer. It appears that your mother –in-law has undergone all of the available treatment and unfortunately as you described her condition has deteriorated. I am sure this situation is very difficult for your mother in law and yourself.
The feeding tube does provide nutrition; however, once her organs begin to shut down the feedings will most likely not be absorbed. Because of the need for the body to require nutrients, and as this need decreases, the residual amount of feedings will increase.
Unfortunately the time frame you are questioning is very difficult for anyone to answer, generally speaking once the liver and kidneys begin to lose the ability to filter, toxins increase within the body and will influence a person’s ability to think clearly as well as may cause limitations with mobility.
It sounds like it has been a month since your last physician visit, I would recommend reflecting on the changes you have seen within this time frame and if you are noticing a rapid decline with mobility, cognition and an increase in residual feedings - day to day for example, then I would suspect her health is declining rapidly. On the other hand, if she appears to be maintaining her current level of activity she may have more time, as you stated the physician described. I would suggest the best person to talk with in more detail would be the physician. You may want to plan more frequent visits with him/her to help during this difficult time.
Finally, I would hope that you and your mother in law have some sort of help during this time such as home health nurses, and or hospice care. Being able to evaluate the feedings and the day to day activity both physically and emotionally can be very difficult both for you and your mother in law. I think having professional health care providers helping in a home setting may ease some of this stress.