The Cyberknife brain radiation certainly made mom tired. We were expecting it, at least partially, because she was tired going into it and her body is fighting off the cancer.

Monday we had an oncologist appointment. Mom had a bunch of different symptoms and we could not tell what might be cause by Sutent (sunitinib – the targetted therapy), brain radiation, or cancer progression. In addition, she has also been on a steroid which also causes side effects. Unfortunately, the oncologist believes that at least some of her symptoms are caused by cancer progression. We cannot know for certain yet, but that was what he believed he was seeing.

The next steps are really going to depend on how mom reacts to the second dose of Sutent The oncologist did agree to order a CT for the next scheduled visit, which is in three weeks. This early on, the best that we can hope for is for the Sutent to stop the progression, and then after a couple of months it may actually shrink tumors. However, if the cancer did indeed progress this last week, then it likely means that the Sutent isn’t working.

Her cancer could progress quickly, or it could take a pause and not progress. We really won’t know, but likely will have an idea by sometime next week. She starts her second cycle of Sutent tomorrow. If it doesn’t work, then given the extent of her lung mets, her health will fade quickly.

We met with the palliative care doctor today, to better manage mom’s pain – here, the oncologist defers all pain management to palliative care. In additional, all end-of-life is managed by palliative care (or if we choose, in-patient hospice).  We had a chance to talk over a few things with the doctor, but also learned that we need to go back to mom’s care coordinator to get a better sense of options. The care coordinator is the one responsible for things like hospice beds and other resources for home care support. As mom approaches end-of-life, if not in hospice, they can provide some nursing services, but likely not 24-hour nursing. In reality, a lot of the care falls on the family.

We are at the moment hoping for the best, but planning for the worst … the biggest thing is ensuring that mom isn’t in pain.

I’m doing OK for now. We got the pool up and running (thank you hubby – it was no small feat). So now, I can enjoy an early evening swim.