My mother has just passed after almost a year battling lung cancer. My sisters and I are convinced that WBRT played a key role in her quick demise. But, how do we separate this impact from the impact of the metastasis of the cancer to the brain?
She was weak but fully ambulatory before the start of WBRT. Within a few days of the start of WBRT, she became less mobile and cognitive thinking was impaired. After a week of WBRT, my mother could not walk without assistance, feed herself, or sign her name!
We had been told that WBRT would "kick her in the butt" (e.g. make her super-fatigued). Otherwise, we were told that it could result in some memory loss, hair loss, and maybe some nausea. We could not get anyone to discuss more permanent side effects.
Our mother was very worried about WBRT despite agreeing to go through with it. She was worried about the long-term effect on her brain.
Her MRI had shown eight small brain lesions. She had experienced nausea and vomiting, and she had been started on Decadron 4 mg twice a day.
After just eight treatments, she became agitated when placed under the mask. She told the technicians she couldn't breathe and that they were killing her when they made her lie flat. She was panicked because she felt like she was being smothered!
After trying Xanax to relieve the anxiety, my mother could not lie flat or tolerate the mask. She was hospitalized when the dose of Xanax made her stop breathing.
She began to spiral immediately downward. She was totally breathless upon exertion or lying less than 45 degrees in the bed. She began to beg all of us, "Please, help me!" Her memory lapses increased.
When she went into the WBRT, she was not in the dying process, but it was clear that now she was! She began to show increasing periods of apnea. Her chest x-ray showed increased pleural effusion and pneumonitis post-radiation treatment.
Did WBRT hasten my mother's death? We believe it did. My mother kept a daily journal in her treatment, and just three days after the start of WBRT, her entries stopped completely. Her last entry is almost illegible!
We asked for an enhanced MRI, but my mother could not tolerate lying flat. A CT scan of her head didn't show anything. Despite extreme SOB on exertion, my mother's oxygen saturation was always above 90. She felt like she was being smothered.
Any thoughts? We feel now that we should have guided our mother to forego the WBRT---the just use steroids and stay comfortable. The outcome would have been the same possibly, but our mother would have been spared the debilitating side effects of the WBRT. It was just a nightmare!



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