It’s a question I didn’t want to write: How do people die from lung cancer? At the same time, it’s an important question for a few reasons.
Most important is that, if we know how death may occur, some lung cancer deaths may be prevented. Knowing the causes may also help us improve the quality of life for people in the advanced stages of lung cancer. For example, by knowing that blood clots in the legs (which can break off, causing pulmonary emboli) cause a certain percentage of lung cancer deaths, family members can familiarize themselves with the signs of blood clots and help their loved one seek medical care if a clot is likely present.
Another reason to discuss what causes death from lung cancer is for the benefit of family members - at least family members who ask the question I did when my father had late stage cancer: how will he die? I wanted to know the answer so I would have some idea of when to call the rest of my family to gather near. And to be honest, I also feared that he would have a lot of pain.
Before reading on, I’m aware of how difficult it can be to read these words if you have a loved one who is nearing death. Even if it’s totally expected, death is never easy. If you are alone, it might be best to wait until you can look at this information with a friend or loved one, who can be a shoulder to lean on.
Causes of Death From Lung CancerThere hasn’t been a lot written about the causes of death in lung cancer patients, but a recent study broke down the immediate and contributing causes of death for 100 people. The percentages might vary between studies, but this study does give us an idea of what to expect if a loved one is in the later stages of lung cancer.
- Tumor burden
The presence of tumor was the cause of death in 30% of people with lung cancer, a statistic that was further broken down to 4% of people dying from "tumor load" in the lungs, and 26% due to "tumor load" from metastases. What this means is that the amount of cancer tissue present either in the lungs, or regions that lung cancer spreads to (most often the liver, bones, the brain, and the adrenal glands), led to death.
Infections were responsible for death in 20% of the patients. For 12 of these people, it was pneumonia; for 8, it was sepsis. Sepsis is best described as an overwhelming infection that begins in the bloodstream and spreads through the entire body.
- Complications of Metastatic Disease
When lung cancer spreads to other regions of the body, it can interfere with the normal functioning of those organs. For example, if lung cancer has spread to the brain, it may interfere with normal brain functions such as the ability to walk, talk, and swallow, or even result in a hemorrhagic stroke. The spread of lung cancer to the liver can interfere with the liver's ability to do its job of removing toxins from the body, and the buildup of toxins may in turn cause death (this is usually painless, as people slowly become less alert). The spread of lung cancer to the pericardium (the lining surrounding the heart) can result in bleeding between this lining and the heart, resulting in compression of the heart and subsequent death (this is often rapid and painless). These complications were responsible for 18% of deaths.
- Pulmonary Hemorrhage
Pulmonary hemorrhage, or bleeding into the lungs, was responsible for 12% of deaths.
- Pulmonary Embolism
Blood clots (deep venous thrombosis) in the legs that break off and travel to the lungs (pulmonary emboli) caused 10% of lung cancer deaths in this study — a significant finding, as blood clots are sometimes preventable, and often treatable.
Looking at the causes from a functional standpoint, respiratory failure was the immediate cause of death 38% of the time, whether caused by tumor load, pneumonia or hemorrhage. It’s important to note that most people had more than one mechanism contributing to death.
Other Possible CausesThis was just one study. Looking at causes of death from all types of cancer, other possible causes may include:
- Complications of treatments such as chemotherapy and radiation therapy.
- Medical errors.
- Medication errors.
- Complications of surgery, such as anesthesia complications and bleeding.
- Conditions unrelated to the cancer, such as heart attacks due to blockages unrelated to the cancer.
In asking about causes of death, what many people fear is that their loved one will suffer as he/she dies. It's important to note that, even though it's common for people to stop eating and drinking near the end of life, the sensation of hunger and thirst also declines. Regarding pain and difficulty with breathing, the majority of people can be kept comfortable under both conditions in the comfort of their own home. The care and comfort of people who are dying has changed drastically with the use of hospice programs, which can also be a tremendous source of support for the families of those who are dying.
Final ThoughtsWhen talking about death, many people experience grief that’s not unlike the grief that occurs after an actual loss (anticipatory grief). Grieving before death is not only normal, but may allow families to come together to heal from past hurts and form memories that will never die.
- What Happens in the Final Stages of Lung Cancer?
- The Dying Process
- Nearing Death Awareness: A Dying Person’s Awareness That Death is Near
American Cancer Society. Questions People Ask About Cancer. Updated 01/25/13. http://www.cancer.org/cancer/cancerbasics/questions-people-ask-about-cancer
Machtay, M., and E. Glatstein. ”Just Another Statistic:. Oncologist. 1998. 3(3):III-IV.
Nichols, L, Saunder, R., and F. Knollmann. Causes of death of patients with lung cancer. Archives of Pathology and Lab Medicine. 2012. 136(12):155-7.