What should you know about lung cancer final weeks?

A person may sleep more, eat and drink less, become weaker, or spend more time in bed. Breathing can become irregular or noisy, and secretions may collect in the throat. Confusion, restlessness, cooler hands and feet, or less conversation can also occur. The timing and combination differ from person to person.

These changes do not mean the person is choosing to withdraw. Medicines and illness can affect alertness. Palliative care can treat pain, breathlessness, nausea, anxiety and other distress while supporting the family.

Ask the treating team for a clear plan covering medicines, mouth care, repositioning, oxygen or other breathing support, and who to call at any hour. Offer small sips only if the person is awake and wants them; do not pressure food or drink. Speak calmly, reduce noise, and say who is present even if replies are limited.

Discuss the person’s preferred place of care, emergency wishes, spiritual needs and important contacts. Chemotherapy or radiotherapy may sometimes relieve symptoms, but decisions should reflect likely benefit, burden and the person’s goals.

Call the care team promptly for uncontrolled pain, severe breathlessness, agitation, repeated vomiting, new bleeding, a fall, or a sudden change in alertness. Call emergency services for a severe breathing crisis or heavy bleeding when that matches the agreed care plan.

Which changes should we expect, and which require an urgent call? Who is available overnight? How should prescribed medicines be given if swallowing becomes difficult? What can we do if breathing sounds noisy or the person becomes distressed?