rivers2cross

Since mum died of bowel cancer in 2016, I have been left with questions about the the use of steroids in cancer treatment, in particular about during her final months when the cancer had spread to her brain.

Mum had stage four bowel cancer, and for four years the cancer had been coming back to her left lung, and she had surgery four times to remove cancerous nodules. Towards the end of 2015 her lung surgeon decided to remove the lower lob of her left lung. It was while Mum was waiting for this surgery that she had her first seizure, which put her in hospital, and it was discovered that the cancer had also spread to her brain in the form of two lesions. I look back as this really marking the moment when Mum’s health began its decline.

Mum underwent CyberKnife treatment for the lesions, followed by surgery to remove the lower lob of her left lung. Sadly over time it became apparent that the CyberKnife treatment had not been completely successful, and she was still having seizures. To try and reduce the swelling on the brain and stop the seizures she was put on high dose short term courses of steroids. The problem was that once the course of steroids finished something else would happen. It was a worrying time…

At the beginning of June 2016 she had the big seizure that put her in hospital for the final time. The effect of the seizure was similar to that of a stroke. She was paralysed down her right side, and it severely affected her speech. Once again she was put on a high dose course of steroids, and these had a massive effect on improving her speech and movement. She was able to talk to a good standard, and got limited movement back in her right arm.

However, it was at this time that we were told that the treatment options had run out, and that mum was too weak to go through intense radiotherapy, and that she would be put on end of life care. The plan was to move Mum to a nursing home where she would be on a “pathway”. While a nursing home was sought it was agreed that Mum would stay on the high dose of steroids, and during this period she was on great form and even began to go out into the hospital gardens to enjoy the summer sunshine, something she had always loved doing as a complete sun worshipper.

After almost two months in hospital Mum was moved to the nursing home. She hadn’t wanted to return home it was like she had said goodbye to that part of her life. The steroids were gradually reduced and this meant that her speech deteriorated as did her movement down her right side which she found so frustrating. On August 22nd 2016 she turned 80, and we managed to take her out of the home for lunch. A very special time, but it had become clear that she was suffering, and that the spark she’d had throughout her cancer had gone. We were able to talk to a doctor who agreed to increase the steroids to try and improve things, but it was to no avail and she died peacefully on August 29th 2016.

What I still haven’t completely understood is why Mum couldn’t have stayed on a high dose of steroids long term throughout those final weeks? The benefits were huge giving her a much better quality of life. I understand that a high dose of steroids is not sustainable long term, but in Mum’s case she was dying, so it’s not like any harm they might do would be any worse? This has been bugging me, and I’ve yet to find an answer. To be fair the end of life pathway Mum had was done really well, and the staff were brilliant taking great care of her. It’s just the steroid thing that I haven’t quite fully understood yet. . . I suppose looking back although things were fully explained to us at the time it was a lot to take on board during a difficult and stressful time.

If anyone reading this can enlighten me a little I’d be really grateful x