Living with Lung Cancer

My husband was having a pre-op exam January 2007 for a routine hernia repair when a huge abdominal aortic aneurysm was discovered by CT scan, along with a suspicious shadow in his lower right lung. He had successful aneurysm surgery the next day, but that suspicious shadow was not diagnosed as Stage 3 non small lung cancer until late June of 2007. He was instead treated for COPD since the doctors felt his overall oxygen blood levels were a bit too low, and he was placed on powder inhalants for several weeks. The inhalants started a round of coughing that only got worse and worse and his oxygen levels dropped lower and lower. He was even treated with antibiotics for possible pneumonia during that time.

He was rushed back to the hospital in late June in a severe breathing crisis, with oxygen levels in the low 70’s. After the biopsy and diagnosis for non small cell lung cancer he remained in the hospital and began a round of daily radiation treatment, along with a once a week chemo session - treatment lasted for several weeks because he developed severe breathing crises during treatment and had to be pulled out of radiation/chemo to be treated for pneumonia etc.

It had been determined his lung cancer was inoperable since the tumor was wrapped around and pressing against a bronchial tube in his lower right lung lobe and his left lung was not healthy enough to sustain him. So, his treatment was stretched out from the first week of July into the first week of September. He remained all that time in a hospital facility because he was totally dependent on high pressure oxygen from the wall. When he was finally released from the hospital in September, his oxygen levels were much improved, he was no longer incessantly coughing, and he could use a portable oxygen tank, but he was very weak and extremely tired.

He began chemo again in October after six weeks to recuperate, but had to fall back out of treatment with yet another breathing crisis that put him back in the hospital. He had an extremely inflamed esophagus from radiation and had to swallow a mix of benadryl, lidocaine and Maalox just so he could eat - that went on for weeks. He developed fluid buildup in the membrane outside his right lung. He was told by his doctors that his original tumor had been effectively reduced to one third its original size but he had traded one problem for another - he now had radiation induced fibrosis of his lungs.

A bedside procedure was performed to drain fluid from his chest cavity in November. In the meantime, he had spent two weeks of October and another two weeks of November in the hospital for breathing difficulties. Fluid began to build back up in December and he was now using two oxygen concentrators at home to provide him with sufficient oxygen to remain comfortable - six to eight liters. He was readmitted to the hospital January 3rd, 2008 and a special procedure was performed to drain more than three liters of malignant pleural effusion from his chest cavity and to collapse the membrane permanently against his lung so that fluid could no longer collect there. He was dependent on 15 liters of oxygen from the wall and on an oxygen mask for the duration of his hospitalization. He was also treated with powerful antibiotics for pneumonia after three strains of pneumonia were identified. He lapsed into a coma early Sunday morning on February 3rd and died a few hours later.

Was his treatment worth it? Well, the combination radiation/chemo certainly ended his terrible coughing spasms. However, I do believe the radiation treatment also caused irreparable damage to his diseased lungs - he had late-effect radiation damage - most likely the source of his pneumonia and the weeping of fluid into his chest cavity, much like what happens when one burns their skin and a blister forms. He had originally been told on the day the doctors told him he had lung cancer that he had six months to a year to live. The oncology doctors gave him hope that his survival time could be much improved with treatment and he could most likely extend his life, perhaps by one or two more years. He lived eight months. When asked if he wanted to pursue treatment, he would always say, “of course, what other choice IS there?”

He was all about life - savoring every precious God-given moment of living and not surrendering to death any sooner than absolutely necessary. There were doctors he encountered who did not understand his philosphy, who wanted him to face the inevitable and accept that he was a dying man. Hospice personnel came to talk with him daily and the hospital pressured him to be discharged - the problem was there wasn’t any facility in our area who could meet his oxygen requirements. Apparently it is not ethically correct to remain in a hospital to die these days especially if one seems to be taking longer than usual TO die! I consider it a dangerous trend in medicine today, influenced more by rising expenses for treatment and hospitalization than by any humanitarian concerns. We had ample insurance coverage, but hospitals and insurance companies have their own agenda. In fairness to hospitals, they all too often are reimbursed by insurance companies or the government (Medicare) for only a fraction of what they charge for treatment. My husband never gave up hope, but he accepted his fate with dignity and grace, in spite of it all.