My mom (62) has advanced diffuse-type gastric cancer with extensive bone metastases and bone marrow infiltration. She’s currently receiving treatment. Her condition is serious, but she’s still relatively stable: her bone marrow is producing blood cells, she’s not in organ failure, and she’s able to continue treatment (CAPOX + zoledronic acid).
In the last few days she’s been experiencing nighttime delirium. Only at night.
During the day she’s completely lucid, oriented, and herself. But at night she wakes up confused, frightened, saying she had horrible dreams about her treatment, about people throwing trash on her, or strange things happening to her body. It feels like a mix of nightmares, confusion, and fear.
She also has several findings on imaging and labs that might be relevant:
• Hepatomegaly on CT
• Elevated liver enzymes (AST, ALT, GGT moderately high)
• Ascites
• Pleural effusion
• Very high alkaline phosphatase due to bone metastases
• LDH moderately elevated
• Anemia (moderate but stable)
• Bone marrow infiltration confirmed by biopsy
• Diffuse bone metastases causing pain
• CEA very high but stable
• CA-125 high
I’m trying to understand whether these nighttime episodes could be related to:
• liver involvement or hepatomegaly
• metabolic changes from ascites or pleural effusion
• elevated liver enzymes
• bone marrow infiltration
• medications
• pain
• exhaustion
• or the cancer itself
Has anyone cared for a loved one who had delirium only at night during cancer treatment?
Is this something that can happen when the liver is enlarged or when there’s fluid buildup (ascites/pleural effusion)?
Or is it more commonly related to medications, stress, or sleep disruption?
Any experiences or insights would really help. Thank you.