End of Life Symptoms From Colon Cancer

Dying from colon cancer in the end stage means that treatments are no longer working or need to be stopped due to side effects. The cancer has spread throughout the body, and the condition is considered terminal. However, the timeline for when a person passes can vary significantly.

There are several symptoms seen in individuals with colon cancer that indicate death may be near. These can include:

• Fatigue
• Breathing changes
• Confusion and agitation
• A rally, or moments of clarity during the dying process
• Jaundice, if the liver is impacted (a common place for colon cancer to spread)

Understanding what to expect during the end stages of colon cancer can help you and your loved ones prepare.

Pain

One of the most feared symptoms of death is pain. If your loved one is dying from colon cancer, they most likely have diffuse ​metastases. That means their cancer has spread from the colon to other organs and lymph nodes. Metastatic cancer often causes pain in the location where the cancer has spread.

When someone with cancer experiences pain, their healthcare provider may prescribe opioid narcotics or powerful pain medicines. If your loved one cannot swallow the medicine, you can give some preparations sublingually (under the tongue) or rectally as a suppository.​

Individuals nearing the end of life often sleep a lot more. This can make it challenging to know if their loved one is in pain. However, even at rest, there are signs of discomfort that you can watch for:

• Grimacing and frowning
• Breathing quickly
• Fidgety arms, legs, and feet

Before assuming pain is present, check the environment. For instance, there may be simple reasons for these signs of discomfort, such as wet sheets or a fever.

Withdrawal

Coming in and out of consciousness is typical during the weeks before the end of life. But in the days and hours preceding death, most people enter a sleeping or almost comatose-like state.

Withdrawing is not a voluntary choice—your loved one is not ignoring you. Similarly, this withdrawal is not an effect of the medications they are taking for comfort, as many family members fear.

It is not entirely understood why people withdraw, but it may be a combination of physical and mental exhaustion from fighting illness.

Changes in Breathing

Changes in the way your loved one breathes might be a signal that the end of life is approaching. For example, if you start to see pauses between breaths or hear an audible gurgling noise, also known as the death rattle, your loved one is most likely within hours of passing on.

To make them more comfortable, try elevating the head of the bed and consider offering less fluids. Fluids can accumulate in the throat and make gurgling worse. However, reach out to their hospice nurse or healthcare provider before withholding or significantly decreasing fluids for a significant time.

Agitation and Confusion

Symptoms at the end of life can include periods of confusion, agitation, and even hallucinations. Your loved one may see things in the room, angels, or even people you cannot see. They may not recognize you, think you are someone else, or seem upset and out of sorts for no apparent reason.

Medications may help calm them and decrease these symptoms. Try not to escalate the situation by arguing with them or letting them know what they're seeing isn't there. Instead, give them calm, gentle reassurance.

The Rally

A rally happens when someone who is dying develops moments of complete clarity or alertness. They might even request food after abstaining for days. Not everyone will experience a rally at the end of life, but it can confuse ​the family if they do.

Some family members might see this as a hopeful sign that their loved one is improving. No one knows why some people experience this and other people do not. A rally may last up to a few days or occur just for a moment or two before death.

Other Symptoms When Someone Is Nearing Death

Other symptoms that the body is shutting down and an individual is close to passing include:

• Cold and mottled skin due to decreased circulation
• Extreme weakness and sleepiness
• Difficulty swallowing (food, pills, and medication)
• Loss of bladder and bowel control
• A build-up of mucus in the throat (and unable to cough it up)
• Blurry vision and decreased hearing as senses change

When an individual has passed, their breathing and pulse stop, they may eliminate stool and urine, and their eyes stop moving but may remain open, with their pupils remaining large and non-reactive to light.

Symptoms of Advanced Colon Cancer

For those with localized colon cancer (cancer that has not spread), the five-year survival rate is 91%. Meanwhile, for those with stage 4 colon cancer that has spread to distant regions of the body, their five-year survival rate is 13%.

How quickly colon cancer leads to death depends on several factors, such as how much the cancer has spread, your age and overall health, how well the cancer responds to treatment, and more.

Stage 4 colon cancer is often considered terminal cancer. This is because cancer that has spread throughout the body is far more challenging to treat. Typically, treatment options such as chemotherapy and surgery can lengthen how long someone lives but not get rid of the cancer.

The early stages of colon cancer are often asymptomatic. As the disease progresses, signs and symptoms of progressing colon cancer may include:

• Rectal bleeding
• Abdominal pain
• Changes in bowel movements (e.g., diarrhea)
• Anemia

Additional symptoms of colon cancer may include:

• Unattempted weight loss
• Fatigue
• Vomiting

The liver is a common place for colon cancer to spread and can result in jaundice. Additionally, the liver, abdominal wall, and ovaries (in females) are other common places of spread. Colon cancer that has spread to the lungs may cause a cough, shortness of breath, or other respiratory symptoms.

Summary

It is often helpful to understand the death and dying process when colon cancer is terminal. Understanding what to look for can help ease worries and bring peace of mind for caretakers over what to expect.

Healthcare providers will likely ensure your loved one has pain medications to reduce discomfort. Many individuals receive care from specialty providers such as palliative care providers and hospice nurses.

In the final days and weeks, sleeping a lot, confusion, and changes in breathing patterns are common. Some people, but not all, develop moments of clarity and alertness soon before they pass.