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My grandfather is 73 years old and has battled cancer for the past 15 years. He was cancer free for many of those years that I've been till about three years ago it had came back. He has had many surgeries and many treatments since it has returned. But with this last discovery of cancer that has spread to multiple locations so chemo is the only option. He's been on chemo for the past month he has been experiencing a lot of pain. He has lost a lot of weight. He has been getting frustrated and angry more often which is the opposite of his personality. He does not want to eat anymore and just wants to sleep. He is not in a hospice facility he is at home with my grandmother. Because of his recent actions of him not wanting to eat and just wanting to sleep more my question is, "this the beginning of dying?" He has stated that he doesn't want to be here anymore but I'm not sure if it's just the pain that's talking or if it's a real thing. If you guys could help I would appreciate it. Thank you.

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Alice, I'm so sorry to learn of your grandfather's challenges and trials from cancer. I do think you're wise and insightful to notice the changes with this current round of chemo.

I think you can clarify whether or not he's in a dying stage, and take actions as appropriate, such as providing the support he needs during this challenging phase.

1. Ask his oncologist; he/she's the most likely to be able to interpret the extent of the metastasis, whether it's affected vital organs, and an estimate duration of life. Ask what stage the cancer is in. Ask which organs are affected, what the duration is before they're severely compromised.

I.e., my sister's lungs had been infiltrated by cancer, she was in respiratory failure, had trouble breathing, had a pleural infusion, was on oxygen and was miserable. Lung compromise was severe, but so was the compromise when her bones were affected by the extensive metastasis and she could barely stand. (She was a runner at one time before cancer made its unwelcome entrance into her life.)

2. If it's a terminal stage, raise the issue of d/c'ing the chemo; if it's not going to help, why put him through the agony? This is what my sister's oncologist recommended as she was clearly not getting any benefit from the chemo, so why go through that miserable ordeal?

3. Will, or can he eat anything? During my sister's last stage it was hard to find food that appealed to her. We found that thick juices and nectars like apricot juice were tolerable, as were salty foods such as sausage. At that point, she needed anything with calories and nutrition.
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Is the cure worse than the illness at this point? It's a common tipping point people reach with serious illness. Docs instinctually keep "healing" and fixing. It's what they're trained to do. But they don't  always have honest conversations with the patient and families about the harsh realities of illness, treatment options, hospice and dying. Read the excellent book, "On Being Mortal" for an excellent look at this topic.

I don't know if it is the case with your GP, but I think it's justified for people to quit the battle. Sometimes enough is enough. There is no shame in such a decision.

I hope I have the courage and presense of mind to do so if I were in this position.

I agree with GA that you and your family have a serious talk with his treating doc as to where this is going and maybe discuss a possible hospice evaluation.
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