Diagnosing signs of death in brain cancer can be unreliable in a small percentage of cases. Sometimes miraculous recoveries occur and patients regain their functioning and lead normal lives. However, in most cases of brain cancer, there are concrete signs that precede death. When stage IV of brain cancer sets in and loved ones begin to notice changes in functioning, eating, sleeping and complaints of headaches and intense pain, they should prepare themselves for the end.
When a patient enters stage IV of brain cancer there is no more a hospital can possibly do to rehabilitate him or her and the patient is told to return home and expect death. Stage IV is the final and most invasive, extreme and painful stage. In this stage the tumour has metastasised out of control in the brain, swelling the tumour until it can no longer be reversed, ensuring certain death.
Eating and drinking
One of the earliest signs of death in a patient is cessation of eating and especially drinking. Patients will begin to routinely refuse food and deny feelings of hunger. Patients usually die 3 to 5 days after taking their last drink. Nausea may also set in with vomiting, making eating impossible or undesirable. The body is no longer able to maintain itself with basic, vital nutrients like food and water and begins to shut down rapidly as the brain commences to die.
Another telltale sign is changes in breathing. Patients may breathe more rapidly, take long pauses in between breaths or breathe louder. Breathing may also become more laboured and mucus will be present, choking the breathing process, making audible sounds of discomfort.
In this stage, the cancerous cells creating the brain tumour metastasise wildly, producing more and more deadly cells in the brain, causing the tumour to swell intensely and overtake the brain. The tumour quickly begins to effect cognitive functions such as thinking patterns, thought processing and abilities to grasp abstract concepts. Motor skills will fail as well and the patient may fall, be unsteady and uncoordinated, and possibly suffer muscle spasms. The patient will have trouble doing simple tasks for him or herself that were once easy and may have trouble with memory. The patient's speech patterns will deteriorate along with thoughts and he or she may be incoherent, stop in the middle of sentences or relate stories or sentences with no logical reason.
Doctors use clinical symptoms to gauge the patient's proximity to death. All of the following clinical scenarios display that the patient is in close proximity to death and can no longer be treated as determined by his or her doctor: If MRI scans indicate that the tumour has grown dramatically since the last visit and is becoming larger and larger uncontrollably over a small span of time, if the cancer cells have spread to other parts of the body rapidly, if there are more "satellite" tumours (tumours on other parts of the body), if the tumour has spread to the spinal cord, if the doctor dismisses the option of further radiation treatment and if the patient's Karnofsky Performance Status is 50 or below.
At this point doctors may suggest home health, hospice care or care administered by a loved one to see the patient to through to the end of his or her life. Providing comfort, courage, joy and companionship is one of the most important things a loved one can do to help a patient find peace during this final stage of life.
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