A very sad conversation.

January 4, 2008 8:40 AM

My very good friend was diagnosed with "Gastric Adenocarcinoma, Signet Ring Cell formation" yesterday - a really rare form of aggressive stomach cancer. What is going to happen?

His doctor originally thought it was IBS, so he's been losing weight for the last year or so, looks about 10 years older (he's 42), and recently had to go to hospital where they drained 2 liters of fluid (aceites?) from his abdomen. I don't want to plague him with questions right now, but I have many.

He's let me know that it will almost certainly be fatal, and its advanced enough that they aren't really even treating it, just trying to make him comfortable.

What is going to happen to him as this progresses? What can we as his friends do to make him more comfortable?

posted by uaudio to health & fitness (8 comments total)

I am really sorry to hear about your friend.
I have never been in a situation like this, although if I were, I would do a lot of listening.

He is probably going through a lot of emotions right now.

Depending on his personality he might want to talk about it all the time, not talk about it at all, or somewhere in between. You should be ready to cater to any of these situations.

Also depending on his mood, social and financial status (and the level of closeness you have with this person), he might need you to help him get his "affairs in order" (i.e. finalize his will, contact family/friends, funeral arrangements, make sure his family is taken care of) - or maybe he might want to do a few things that he never had a chance to do (i.e. skydiving, going to Vegas, whatever).

I am really sorry that he has to go through this and that you, his friends and family have to go through this too.

Be strong for him - Be strong for yourself. Be there for him. Be there for yourself.
posted by bitteroldman at 10:35 AM on January 4, 2008

It's hard to know what exactly will help your friend, but here's a nice list of general suggestions from a hospice:

How to help friends and families facing a serious illness
When someone we know is facing a serious illness, we often feel helpless. Here are some practical ideas for helping an individual who is seriously ill, as well as that individual’s family.

* Don’t avoid the individual. Be the friend you’ve always been.
* Include your friend in decisions. Don’t deny him or her a chance to make decisions in his or her life.
* Don’t always feel that you have to talk. You can sit quietly together, offering a simple squeeze of the hand, which says you care.
* Call before you visit. If your friend is not up to having company, he or she will be honest with you.
* Take your friend out for a pleasure trip, but know his or her limitations.
* Water your friend’s flowers.
* Offer to stay with your friend to give his or her loved ones a break.
* Bring your friend a book of thoughts, taped music, a poster, or cookies to share with his or her family.
* Offer transportation for a doctor’s appointment, shopping, or family needs.
* Bring magazines, photos, newspapers, and verbal reports to keep your friend from feeling the world is passing him or her by.
* Help out with some of the cleaning.
* Just send a card to say, “I care.”
* Don’t be afraid to share his or her emotions, laughter, sorrow, and fears.
* Help celebrate his or her life by decorating the hospital room or home.

This page on Coping as a Carer also has some good practical and emotional advice. I think most important is the idea that you should be willing to talk about the disease, and his fears, as openly as you can (and as openly as he's willing to), without minimizing them or freaking out. Which usually means that you'll need your own support network where you can freak out when you need to -- which is fine, facing anyone's death is enormously difficult -- without putting a burden on your sick friend to always put on a happy face so that he doesn't upset you.

I'm so sorry that you and your friends are having to go through this, and I wish you strength and support as you do.
posted by occhiblu at 10:43 AM on January 4, 2008 [1 favorite]

Actually, rereading that list I posted, one thing that stands out is the idea that you should "Bring magazines, photos, newspapers, and verbal reports to keep your friend from feeling the world is passing him or her by." It's not bad advice, but if your friend starts seeming un-interested in outside affairs, that's normal, too. There's kind of a balance between "not wanting to focus exclusively on the illness" and "coming to terms with a lot of internal stuff" that may tend to shift as the illness progresses, and that's normal.

Another thing you may want to do, if it's something that fits within the relationship you have with your friend, is to help your friend make some sense of the meaning of his life. That may mean assembling photo albums, or listening to (or even recording) his stories about his life, or maybe telling him stories about his life that are meaningful to you, or something else entirely. Certainly don't force arts and crafts projects on him, but if there are openings in which you can explore a bit about what his life means (to him, to you, to his family, to the world in general), that might be rewarding for both of you.
posted by occhiblu at 10:51 AM on January 4, 2008

how to talk to a friend with cancer
posted by forallmankind at 2:40 PM on January 4, 2008

There is a book called Share the Care: How to Organize a Group to Care for Someone Who is Seriously Ill. Some friends of mine found it really helpful when a beloved friend of theirs had cancer.

In my experience, when someone is in crisis, it helps if there is a pyramid of support. The people closest to the sick (or in crisis) person are in caregiver mode, and also need support themselves. If you're the filling in that sandwich, it can be good to keep in mind that you might need help or support, too, since your sick friend is not going to be in that role for you--you might need others to pick up some slack in your life so you can be there for your friend, you will probably need other people than your friend to talk about your feelings about his illness and death with, and so on. You'll be offering help; remember it's OK to ask for it, too.
posted by not that girl at 7:13 PM on January 4, 2008

The listening part is definitely the most important part, but I have a practical suggestion as well.

Hospital clothes suck. You're baring your ass half the time; it gets drafty. I don't know if he's still in the hospital or not, but hopefully they will let him wear as close to street clothes as he can. My mother, for whom I am a part-time caregiver, has ascites too. It has complicated the clothes she feels comfortable in. If your friend is going to continue to have a swollen, distended tummy, a kind thing you could do would be to find warm enough clothes that still don't constrict that area of his body. For my mom we did warm nightgowns, but since your friend is male it might get a little more complicated. If, however, after draining the fluid he has changed size and gotten smaller, probably none of his old clothes fit and you could pick up some new, smaller ones for him.
posted by RobotHeart at 6:31 AM on January 5, 2008

I should add two things:

If your friend is losing weight, it's probably not in his tummy unless the draining helped him, and his arms and legs may be skinny compared to his middle, in which case watch out for shoulders and sleeves being too big.

And of course the other biggie is I'm sorry. Obviously the cancer is happeing to him and not you, but of course you're going to have a lot of feelings about this. notthatgirl's advice is good advice in that arena.
posted by RobotHeart at 6:35 AM on January 5, 2008

Thanks everyone - ALL your answers are the best answers.
posted by uaudio at 4:06 PM on January 6, 2008