Coughing and Breathing Difficulties
Many people in the final stages of lung cancer experience an intense cough. Sometimes they may even cough up blood, which can be very frightening but can be managed by the palliative care team. If you experience this cough, it may leave you feeling short of breath and fatigued after each spell. Your palliative care team will work with you to devise a plan to help you remain as calm and comfortable as possible after these coughing fits.
A common fear of lung cancer patients is that they will die feeling like they are "suffocating." This is simply not the case for most patients. Shortness of breath can be managed with medications, oxygen, and other means to help you feel comfortable and relaxed.
In the final weeks to months of life, increasing weakness will make normal day to day tasks very difficult. You may first find yourself unable to walk without assistance then transitioning to a wheelchair and finally confined to a couch or a chair until you are eventually bed bound. Coughing fits may further exaggerate the exhaustion you feel and leave you feeling quite drained for up to hours afterward.
You will become increasingly dependent on others for your care. It is a good idea to make arrangements ahead of time for who will care for you. You may have family that is able to provide your care or you might need to hire professional caregivers or research nursing facilities.
It's very likely that you will experience pain in your final stages of lung cancer. A Harvard Medical School Study showed that 40% of lung cancer patients experienced "serious pain" in their last 3 to 6 days of life. Lung cancer may spread to bones in the chest and spine, which can cause severe pain. Your palliative care team is highly trained in pain management and will work hard to keep you comfortable. There are things you can do to ensure optimum pain control as well.
Decreased Appetite and Weight Loss
Nearly all dying patient experience decreased appetite as the body begins the dying process. The body no longer needs the calories it once did and the gut begins to shut down as the body focuses on the organs most necessary for survival, such as the brain, heart and lungs. It's normal to not feel hungry and it's OK to eat only what you're interested in eating. You will continue to lose weight as your food intake decreases. This is all a normal part of the dying process.
Most people dying of lung cancer will experience anxiety and agitation, even confusion, at the end of life. You may not recognize loved ones. You might be confused as to where you are or what is happening around you. You might experience delirium or terminal restlessness. This can be very upsetting but your hospice care team will be prepared to treat any anxiety or agitation that can accompany confusion. You may want to prepare for this symptom in advance by getting your affairs in order. Make your end of life wishes known, say goodbye to loved ones, prepare your will, and plan your funeral. Say everything you want to say to those who are most important to you. Prepare those close to you for the confusion that may happen so they won't be frightened if it does occur.
Will I Die Peacefully?
The one question almost all lung cancer patient and their loved ones want to know is whether they will die peacefully. Despite all of the symptoms listed above, most lung cancer patients have a very peaceful and comfortable death. Choosing to die with the support of hospice care will ensure that you have 24-hour access to health care professionals and expert pain and symptom management.