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Cancer, what's the killer?

Disclord

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Disclord
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Mar 5, 2008
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Some of you may remember that I posted about my sister being diagnosed with cancer back in February - she had it in her pancreas, lungs and brain. I helped take care of her at home in her last few weeks and she died on May 28th at 1am. Up until 2 days before she died she had absolutely no pain and actually felt fine - she constantly said she didn't feel sick, and was baffled that she WAS so sick. 2 days before she died, the pain started in her leg, like a bad burning... Vicodin didn't help, so the hospice nurses switched her to morphine concentrate (BLUE! which stained her mouth and teeth blue!) and she had to have 10mg every 30 minutes. It made her itch, so around 7pm, we gave her some Benadryl. She took the pills fine, with no problems swallowing. Then, at 9pm, when it was time to take her anti-seizure meds and meds for brain swelling, her swallowing ability was absolutely GONE. She couldn't do it at all, so the nurses switched her to phenobarbital via a sub-cutaneous line. Late that night she slipped into a coma, except for some moaning if a bit too much time passed between morphine doses. At 1am, she opened her eyes, tears ran down her face, then closed her eyes and peacefully stopped breathing.

So, what I want to know is, how exactly does cancer cause death? And how so fast? I mean, she was feeling OK one day and then, BAM! no swallowing, full pain and coma, then death. How does it do all that, and so quickly?
 
What sort of cancer? This is a bit like saying, what happens when you get an infection. There are many many kinds of cancer.

I'm very sorry to hear about your sister, that's a very sad story.

Rolfe.
 
My understanding from my sister the MICU nurse, is that the aggregate illness wrecks the electrolytics. The off balance electrolytes cause a brain seizure, and that's the end. Gratefully.

I guess administration of umm potassium, or is it calcium, could prolong those last few hours, the ones in a coma, but what would be the point? There comes a time...

My brother died in my sister's home, of Pancreas cancer. Best of a bad thing.
 
Disclord said:
Some of you may remember that I posted about my sister being diagnosed with cancer back in February - she had it in her pancreas, lungs and brain. I helped take care of her at home in her last few weeks and she died on May 28th at 1am. Up until 2 days before she died she had absolutely no pain and actually felt fine - she constantly said she didn't feel sick, and was baffled that she WAS so sick. 2 days before she died, the pain started in her leg, like a bad burning... Vicodin didn't help, so the hospice nurses switched her to morphine concentrate (BLUE! which stained her mouth and teeth blue!) and she had to have 10mg every 30 minutes. It made her itch, so around 7pm, we gave her some Benadryl. She took the pills fine, with no problems swallowing. Then, at 9pm, when it was time to take her anti-seizure meds and meds for brain swelling, her swallowing ability was absolutely GONE. She couldn't do it at all, so the nurses switched her to phenobarbital via a sub-cutaneous line. Late that night she slipped into a coma, except for some moaning if a bit too much time passed between morphine doses. At 1am, she opened her eyes, tears ran down her face, then closed her eyes and peacefully stopped breathing.

So, what I want to know is, how exactly does cancer cause death? And how so fast? I mean, she was feeling OK one day and then, BAM! no swallowing, full pain and coma, then death. How does it do all that, and so quickly?
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My first cousin and my Aunt died the same way. I'm sorry.
 
Rolfe said:
What sort of cancer? This is a bit like saying, what happens when you get an infection. There are many many kinds of cancer.

I'm very sorry to hear about your sister, that's a very sad story.

Rolfe.
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The doctor's said it was melanoma - the only treatment they ever did was Temodar and radiation for the brain tumor, but they stopped that after about a month... then they did a colonoscopy, ruptured her colon, she got infected, then they found cancer in her intestines, so they removed some of that, then they found it in her stomach... then, on May 13th, she was put into home hospice.

I just find it so bizarre that she never felt sick or had any pain till the very end... and that when the end came, she went so fast.

One thing she had, that I had never heard of before, was tumors - the doctors called them "Mets" - popping out all over her back, neck, under her breasts, etc... they looked like red golf balls coming out.
 
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Malignant melanoma. Oh dear, I'm so sorry. That's a blood-borne malignancy, where stray cells from the original small skin tumour are carried in the blood and grow to form new tumours wherever they happen to settle out. That's called metastasising, and the secondary tumours are called metastases.

So much depends on where the metastases fetch up - and they can be anywhere, and all over the place. The daughter of a family friend had the same thing and died of a stroke because of a brain metastasis, I believe.

Be careful of exposure to sunlight, and have any unusual or black-ish skin lesions removed as soon as they appear.

Rolfe.
 
Rolfe said:
Malignant melanoma. Oh dear, I'm so sorry. That's a blood-borne malignancy, where stray cells from the original small skin tumour are carried in the blood and grow to form new tumours wherever they happen to settle out. That's called metastasising, and the secondary tumours are called metastases.

So much depends on where the metastases fetch up - and they can be anywhere, and all over the place. The daughter of a family friend had the same thing and died of a stroke because of a brain metastasis, I believe.

Be careful of exposure to sunlight, and have any unusual or black-ish skin lesions removed as soon as they appear.

Rolfe.
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Does melanoma leave some kind of chemical signature? I ask because my sister didn't have any obvious skin lesions - they found it when her right side became paralyzed. Then, after a few weeks of testing, they declared melanoma. She was a sun-worshiper in the 70's - she had a pool and spent every weekend laying out, tanning.
 
I had occasion to be in a cadaver lab for an A & P class, and one of the bodies was a man who'd died from non-Hodgkin's lymphoma. When they opened his abdominal cavity, it was amazing. There was a mass of tumors pretty much filling the abdomen, and no discernible organs. What I found remarkable is that this man was alive up until he died. (I can only think the disease progressed rapidly right at the end, and things probably looked a lot different even a day or two earlier.)

I'm very sorry about your sister. I've been hearing a lot about how dangerous melanomas can be.

To put a positive spin on this, your sister's story (even told here) will maybe result in saving lives that might otherwise be lost. I for one have drastically changed my attitude toward exposure to the sun, and will routinely check for changes in moles--just because of increased awareness of the danger of melanomas (especially not detected early).
 
I'm sorry about your sister.

As I understand it, the primary problem is that cancer competes with healthy tissue for nutrients. It is able to manipulate the body into growing extra blood vessels to it far better than other organs, starving otherwise functional tissue. Growths themselves can also present physical obstructions to normal functions of the affected organ or even close a blood vessel, as probably happened to Rolfes' friend.
Specific cancers can also cause other specific symptoms, which can result in death.

I'm not exactly an expert on the field, but I think that's it.

McHrozni
 
I am sorry for your loss.

I too am most curious to know why your sister felt no pain until the very end.

It's true that much of (inside of) the body does not have pain nerves (if there is such a thing, I know almost nothing about the relevant biology and physiology), so stuff that goes really badly wrong there doesn't necessarily result in pain.

Pancreas and brain - there are no pain nerves in either organ, are there? So the only pain one could feel would come from pressure (due to swelling, say) on some other part of the body where there are such nerves, or where the cancer cells there caused some change in biochemistry that resulted in nerve cells elsewhere going 'pain!' (e.g. the stomach).

Lungs? I don't know; when you have a horrible 'chest cold', it sure feels like nerves in your lungs are screaming 'pain!'
 
Yep, no pain whatsoever... she didn't even feel sick. She said she felt weak, like when you're really tired, but attributed that more to being off amphetamines than anything else. She had narcolepsy, and since the mid-70's had taken, oh, I forget the name - it was a drug that's a mix of 4 amphetamines - it was called Orlistat, I believe at one time. When she was first diagnosed, the doc's took her off it because she wouldn't be driving and such anymore. Even her mind was clear and fine - we'd watch TV and chat all day... then swallowing stopped, coma, death.

I sure hope someone learns something from this - my two surviving sisters haven't and still tan in booths - Debby, my youngest sister, is so dark, and has tanned so much, that she looks like leather. When Suzanne (my sis who died) tried to talk to her about it, she just got mad and stormed out. UGH!
 
Disclord, I am very sorry to hear about your sister. I have a little background in cancer, but mostly from a research aspect. I found an old journal paper that addresses causes of death in cancer patients, but I don't know how relevant it still is, since the paper was published in 1975.

Here is the link to the abstract:
Causes of death in cancer patients

I do know that melanoma can sometimes be very difficult to initially detect and tends to progress rather rapidly. The initial tumor may be smaller than the tip of a pencil eraser, and if left unchecked, can become malignant and spread through the bloodstream to other sites. Melanoma is well known to form metastases (mets) in the lungs and brain, and once it gets going, becomes difficult to stop.
 
Disclord said:
Does melanoma leave some kind of chemical signature? I ask because my sister didn't have any obvious skin lesions - they found it when her right side became paralyzed. Then, after a few weeks of testing, they declared melanoma. She was a sun-worshiper in the 70's - she had a pool and spent every weekend laying out, tanning.
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Since no one else has answered this, I'll take a stab. (That's all it is, mind you.) Once it had metastasized, cancerous cells would be in the bloodstream (and elsewhere). Presumably these cells are identifiable as melanoma cells, so they could make the diagnosis even without a noticeable skin growth.
 
JoeTheJuggler said:
Since no one else has answered this, I'll take a stab. (That's all it is, mind you.) Once it had metastasized, cancerous cells would be in the bloodstream (and elsewhere). Presumably these cells are identifiable as melanoma cells, so they could make the diagnosis even without a noticeable skin growth.
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That makes sense, thank you.
 
Disclord said:
Yep, no pain whatsoever... she didn't even feel sick. She said she felt weak, like when you're really tired, but attributed that more to being off amphetamines than anything else.
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If she felt fine up until the end, how did they find her cancer?
 
ponderingturtle said:
If she felt fine up until the end, how did they find her cancer?
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Her right arm/side went numb - at first the they thought it was carpal tunnel, but then she couldn't use her right arm at all... then the doc's were talking stroke, so she had a full MRI, and the cancer was found. After a few days on steroids, her brain swelling stopped and she got back use of her right side. In mid-March (before the colonoscopy screw up) she had a seizure and couldn't talk for 2 days or recognize her kids - then everything came back to normal.

I forgot one thing - the Sunday before she died, she woke up and her right side was hard to control again, so we got a notary over and had the power of attorney signed. By mid-day, she couldn't use her right arm or leg. She could still feel with them, but not move them. It never caused her any distress, although it freaked me out plenty. She was never scared of dying, just kinda mad and sad because she wasn't going to be around her family anymore and there were so many things she still wanted to do.
 
Actually, I think it would be very difficult to find a melanoma cell in a blood sample. However, if you find a lump, you biopsy it, and then the histology tells you it's a melanoma metastasis.

Rolfe.
 
First of all, I too am sorry for your loss and you and your family have my sympathy.

As a generic awsner to your question. Cancer kills because it grows where it shouldn't do.
Competition for nutrients is some of it, but primarily what happens is that the growths start pushing aside healthy tissue en even breaking it up as they grow larger.
Since cancer cells are formed from ones own body the immune system does not recognize them as dangerous and does not filter them from the blood should they end up there, so a cancer can start spreading across the body.
Unfortunately, the disease being what it is there are a number of major problems in detection and diagnosis.
First, you do not have (many) pain receptors inside your body. So even if something is destroying your internal organs, there is no need for you to feel pain until far too late.
Second, Because the immune system does not react to cancer, there is generally no fever, so people feel fine again until far too late
Third, One cell escaping attention, especially in the later stages can rapidly grow and cause further cancers while currently being undetectable.

There is a massive search for the chemical signiature for cancer to enable early detection, but unfortunately the sheer amount of variation possible inside your blood makes that impossible so far (the composition of what's in your blood varies wildly when you've just eaten, taken a walk, had a drink, had a small fever recently, etc).
 
Rolfe said:
Actually, I think it would be very difficult to find a melanoma cell in a blood sample. However, if you find a lump, you biopsy it, and then the histology tells you it's a melanoma metastasis.

Rolfe.
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The doc's did a biopsy of her pancreas and came to the melanoma diagnosis. They said she'd probably had cancer for many years with no symptoms.
 
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