Lung cancer continues to be the number one cancer killer in the United States today. Lung cancer is often found in late stages, which limits treatment options. End of life care becomes important when current treatments fail, the cancer has spread beyond the lungs or symptoms of dying are present. The final stage of life is commonly referred to as the dying process. This process results in many changes in the body due to multiple organ failure during the final stages of lung cancer.
Breathing Changes
Many breathing changes may occur at the end stages of lung cancer. According to the National Cancer Institute, complaints of shortness of breath occur most often in patients with lung cancer. Breathing appears to become more rapid and shallow. At the end of life, lung cancer patients often experience apnea, which results in cessation of breathing for short periods of time. Noisy and wet breathing are also common symptoms and are sometimes referred to as the "death rattle."
Appetite Changes
In the end stages of lung cancer, most patients no longer become hungry. If hunger does remain, patients often become full with very little food. The Core Curriculum of Oncology Nursing states that metabolism changes due to cancer often steal the lung cancer patient's appetite. At end of life, nutritional needs no longer need to be met as the organs begin to fail. Dehydration also commonly occurs at the end of life and is part of a natural process of the body's multiple organ failure.
Change in Consciouness
The Hospice Foundation of America states that at the end of life, patients become less active and withdrawn. Lung cancer patients at the end of life often sleep most of the time. Patients may also appear to be unresponsive or in a coma-like state.
Restlessness
Not all lung cancer patients experience restlessness at the end of life, but some do. Signs of restlessness at the end of life include picking at bedding or clothes, attempting to get out of bed, confusion, and itching or scratching head or other body parts. According to the National Cancer Institute, hallucinations also may occur as part of the dying process. Many patients even report seeing loved ones that have died before them.
Circulation Changes
The body reserves blood flow for vital organs in the end of life. Lung cancer patients in the final stages often have color changes to the skin. Nails become dusky purple or blue. Skin on hands or legs becomes cool. Mottling may occur to hands and feet, which consists of blue/purple blotching due to lack of oxygenated blood flow.
References
- National Cancer Institute: Final Days of Life
- "Core Cirriculum for Oncology Nursing"; Itano, J. Ph.D, Taoka, K. MSN; 2005
- Hospice Foundation of America: The Dying Process
