End of Life Symptoms From Colon Cancer

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Once treatments meant to halt colon cancer are no longer working, and is considered terminal, it is important to know what to expect. Despite having an advancing condition, the timing of death is very unpredictable.

Usually, in the context of cancer, patients do not experience a "sudden death." Instead, death comes over a period of days to weeks. However, some symptoms are synonymous with the end of life and can be anticipated for comfort.

If you choose, you can discuss palliative care or hospice with your loved one's doctor—these professionals are trained to anticipate and provide symptom relief during the last stages of life and can make a world of difference in the last days and hours.

Holding hands
Kiyoshi Hijiki / Moment / Getty Images


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—or the spread of cancer outside of their colon to other organs and lymph nodes, as well as tumors in and around their colon.

Pain is anticipated, and opioid narcotics, or very strong pain medicines, are most commonly administered. If your loved one is unable to swallow medicine at this point, certain preparations can be ordered and given sublingually (under the tongue) or rectally, as a suppository.​

Many people ask how to tell if someone is in pain if they are asleep, as many people are towards the end of life. Even in rest, there are signs of discomfort that loved ones can watch for:

  • Grimacing and frowning
  • Breathing quickly
  • Fidgety movements of the arms, legs, and feet

Be sure to check your loved one's environment before assuming they are in pain. For instance, there may be simple reasons for these signs of discomfort, such as wet bedclothes or a fever.

Complete Withdrawal

Although you may see this symptom wax and wane during the weeks prior to the end of life, most people enter a sleeping or almost comatose-like state in the days and hours preceding death.

This is not a voluntary choice—your loved one is not ignoring you. Similarly, this withdrawal is also not an effect of the medications being provided for comfort, as many family members fear.

It is not completely understood why people withdraw, but it is assumed that it is 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. 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 do not offer any more fluids at this point. The fluids will add to the saliva pooled in the back of the throat and increase the sound of gurgling.

Gurgling is not thought to cause people discomfort, though it may be distressing to those around them.

Agitation and Confusion

Symptoms at the end of life can include periods of confusion, agitation, and even hallucinations. Your loved one may see insects in the room, angels, or even people that you cannot see. They may not recognize you or may 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. It's best not to argue with your loved one—try calm, gentle reassurance.

The Rally

Not everyone will experience a rally at the end of life, but if they do, it can be confusing to ​family. During a rally, many people develop moments of complete clarity, alertness, and might even request food after abstaining for days.

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 prior to death.

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  1. National Cancer Institute. The last days of life. Updated April 8, 2016.

  2. McGuire DB, Kaiser KS, Haisfield-Wolfe ME, Iyamu F. Pain assessment in noncommunicative adult palliative care patients. Nurs Clin North Am. 2016;51(3):397–431. doi:10.1016/j.cnur.2016.05.009

  3. American Cancer Society. When death is near. Updated May 10, 2019.

  4. AgingCare. When loved ones rally before death. Updated June 11, 2019.