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Hello all again - My 95 yr old mother is on hospice for chf for almost 2 yrs. She also has skin cancer - squamous cell carcinoma. She developed IBC last January - 2020. Started with a pea-sized lump in her left breast and the breast developed the typical red, dimpling on her whole breast. Hospice is aware of this and they check it when they see her. Lately it has gotten so much worse! Multiple Tumors, red/purple in color. It extends under her left armpit. It is shocking to see this. I don’t check it all the time because I can’t take the smell and the visual of it, as it just stays with me all day. But I saw it yesterday. I contacted the nurse on duty. I am worried about infection or septsis. Is this possible? My mother never complains and she says it doesn’t bother her! I can’t imagine that this is the truth. What can be expected from this? I feel this is worse than the other co-morbidities.

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We have often had questions about breast cancer and whether to do surgery in end of life situations. I often recommend removal of the cancer for this reason. It can become just a rotting of the breast while the body lives on. I am certain you are in consult with MD? What is recommended at this time. I am surprised that your Mom is able to stay on Hospice for 2 years. I know they often extend to a year, but it usually becomes more difficult afterward. Whether it is the cancer spreading to other organs unseen, or eventual sepsis and infection, I am not certain whether there is a difference. My bro died of sepsis and the mercy of the thing is that it spreads body wide very very quickly and death comes with speed, rather than the long term torment of breathlessness from CHF and a body part literally decomposing on our bodies. I think the question of what to expect and what to DO now is between your Mom, the POA in consult with MD. I am so sorry. You described her as being up and around still, Nymima, or do I have you confused with another poster who posted recently. I am surprised (but relieved) to know she is still in hospice, but surely she does need it. I am so sorry. How difficult this is. Other families who deal with inoperable gangrene know what you are living with--the assault on the senses is so difficult for families, indeed for nursing staff to deal with. I am so sorry.
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Isthisrealyreal Feb 2021
At this stage of progression, my sister wasn't even offered surgery. They offered chemo and the prognosis was she would live for 8 weeks with chemo. She lived for 7 weeks and didn't have the trauma of being poisoned and losing all quality of life.

You are right, sepsis is right quick and saves much suffering.
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Hospice should be putting a cream and covering on this, just because of the smell and it will start bleeding when touched. The cream contains the smell.

We were also told to put a tray of kitty litter under the bed to help with any escaping odors.

My sister died from breast cancer and it was very much like you describe. It didn't bother her, she was in pain because it had metastasized to her bones and her back was fractured in 6 places but, no pain in her breast.

Ask hospice to use the barrier cream and covering for moms comfort. You will probably have to change it on off days. Just a heads up. If you can not deal with it, I couldn't, get an aid or family or someone else to do it.

I was totally destroyed when I saw my sister for the first time, great big warm hug to you. I do understand how traumatic this is for you.
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nymima Feb 2021
Yes - I will talk to the nurses about the cream. They said they will wrap it when it needs to be wrapped. Her chf is nothing compared to this.....
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