How do I know if Mom has given up her fight with metastic breast cancer?

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Mom has always been so sharp minded and now she stays in a state of confusion.

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If you're into alternative treatments, google sweet wormwood for cancer treatment. There has been some really good luck in animal trials and it is not dangerous.
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That second link didn't copy correctly. You can Google CURE magazine, chemo brain articles.
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Sandi, I see that your mother's cancer has spread to her skull. Do you mean brain, and if so, has she had brain radiation?

Brain rads can affect cognitive function; my sister experienced that.

It could also be a combination of the meds she's taken.

And of course chemo brain.

CURE magazine has some really good articles on cancer related issues:

http://www.curetoday.com/index.cfm/fuseaction/magazine.Landing/id/15

This is a link to articles on "chemo brain", some of which are in the CURE magazine:

https://www.google.com/search?hl=en&source=hp&q=cure+magazine+chemo+brain&gbv=2&oq=CURe+magazine%2C+chemo+brain&gs_l=heirloom-hp.3.0.0i22i30.468.3765.0.5546.26.20.0.4.4.0.250.2628.2j12j4.18.0....0...1ac.1.34.heirloom-hp..4.22.2847.UFx0Cs4-YzE

and just one article addressing the chemo brain syndrome:

http://www.jewishjournal.com/health/article/lifting_the_fog_of_chemo_brain_20091006/

I am so sorry to learn that the cancer has advanced.
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Sandibatspn, sorry your hear about your Mom.... I agree with Pam above about "chemo brain" as the gals in my group therapy where complaining about that..... I am on Tamoxifen and one of the side effects for me is that I don't feel as sharp as I use to be.... had the same problem when I was taking Femara, only worse.

If your Mom has new blood work done, have the doctor check for B12 levels, if that is low, it can make you feel really drained, no energy. Increasing the B12 with shots really helped me.
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Chemo does things to the brain, and this definitely should be discussed with her MD. He may want to do some bloodwork too, to check CBC (cell blood counts) and CMP (comprehensive metabolic panel) to sort things out.
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