One of the most common causes of cancer-related death is lung cancer. Each year, it kills around 2 million people all over the world, which is the same as the population of a small Caribbean island. Common signs and symptoms are cough, shortness of breath, chest pains, etc. On later stages, the cancer can metastasize and spread to other parts of the body.

What to Expect During the Last Stages of Lung Cancer?

1. Fluid Build-Up Around the Lungs

At the last stages, the malignant cancer cells which contain fluid may start to build up in the space surrounding the lungs. This can cause shortness of breath.

2. Obstruction or Bleeding from the Large Airways

Tumors sometimes spread through the airway, which will cause a blockage and subsequent bleeding. 

3. Symptoms Due to Brain Metastases

Whenever the cancer cells spread to the brain, symptoms such as headaches, seizures, speech impairment and muscle problems start to appear. 

4. Fatigue

This symptom is very common due to weight loss even though patients eat correctly. Unintentional weight loss is called “cancer cachexia” and comes with muscle atrophy.

5. Pain

It is a very common symptom that presents almost in all patients who are suffering from last stages of lung cancer. But not everyone experiences pain in the same way.

6. Emotional Changes

Loss of interest in meeting friends or family members and depression are very common emotional changes. Most late stage cancer patients feel irritable when symptoms like fatigue start to appear and limit their everyday activities. 

7. The Final Days

At this point, the patient may go through the "active dying". There are some physical signs that can be noticed, such as:

• No sense of thirst or hunger
• Increase in perspiration. You might notice the skin becoming very wet and with a “clammy” feeling.
• Irregular breathing. This is called chayne-stokes respiration which represents as rapid deep breaths that alternate with periods of shallow breathing. 
• Bluish, blotchy patches on cold skin
• Agitation. Some people say they can see ghosts or even angels.
• A sudden inexplicable surge of energy. Patients may eat a full meal, run or talk a lot more. This can be heart wrenching for family members who believe these signs indicate that the patient is getting better.

Last Stages of Lung Cancer: Treatments

1. For Confusion, Restlessness, and Agitation

Doctor will try to find the underlying cause to treat confusion and agitation if possible. If it is hard to treat the underlying causes, these symptoms can be controlled by calm or pain medications.

2. For Constipation

Some over-the-counter stool softeners (like Colace) or laxatives (like Senokot) may be used to treat constipation in lung cancer patients. These drugs can be found easily without prescription. Ideally, you should always talk with your doctor before taking them.

If these medications do not work, it is better to talk with your doctor who may prescribe you something stronger.

3. For Diarrhea

Your doctor might advise you to take over-the-counter drugs such as bismuth subsalicylate or loperamide.

4. For Depression and Anxiety

This is something very normal at the last stages of lung cancer. You can seek help from the healthcare team if symptoms such as depression or anxiety are getting serious.

5. For Fatigue

• Some drugs might help you deal with fatigue or tiredness. You can take them whenever you need, but try to not take them daily.
• Antianxiety drugs or antidepressants can also help deal with fatigue, but they must be taken with care under your doctor's permission.
• Always talk with your family and your healthcare team in order to get help. When you feel better overall, your fatigue will be also improved.

6. For Pain

Pain medications can be taken whenever you feel like your pain level is at a 3 or 4 on a scale of 0-10. Sometimes there could be difficulty when swallowing the pills, in which case they should be taken through other ways. In worst cases, palliative radiation is given to help deal with pain, which is especially effective when the pain is caused by tumor pressing on nerves.

7. For Shortness of Breath

• In order to improve breathing, physicians have to drain the fluid. Sometimes the fluid is just too much and keeps building up. In this case a procedure called pleurodesis or shunt is performed in order to drain the fluid when the patient is at home.
• Muscle relaxers can be prescribed in order to relax the muscles located in the airways, which can make breaths easier.
• Pain medication as well as oxygen might be used in order to relieve the feeling of breathlessness. 

It is imperative that you tell your healthcare team how effective the treatment is, since there are different steps they can apply to help you deal with this symptom.