Hi Steph,

I've been through this with my Mam as the patient (bowel and breast) and my son has been through it with me as the patient (oesophagus). 

From both perspectives it can feel like you can't do right for doing wrong, walking on eggshells and trying to keep a lid on your fears and emotions.

From a practical point of view - make sure you or someone is with her when her treatment plan is discussed. Write down any questions you have before the consultation and write down the answers. Research shows that patients and family only absorb about 40% of what they are told when they are stressed out and emotional. I've found myself sat in the hospital carpark just ten minutes later reading my notes thinking "I don't remember him/her telling me that!" 

I'm less good on emotional advice but please remember that we all react differently to bad news. People thought I was in denial when I was so calm when hearing my Mam's and my own lousy prognoses, but I was just being practical and pragmatic. Sometimes we find refuge in knowing what to expect next and preparing for that. 

Finally, don't give up hope. Survival rate statistics really are lower at Stage 4 than at earlier stages but remember that these are averages and don't take into account age, sex, pre-existing conditions or general fitness or immune system levels. When diagnosed several years ago  I was told by my oncologist that I had a 5% chance of survival for 5 years. Being a geeky nerd, my response was "that means 1 in 20 patients with my prognosis will survive - when can I start my chemo?"

One last thing - the NHS is in a bit of a state at the moment but that is not your problem. Chase the consultant's medical secretary, be a nuisance, be polite but firm but don't take any nonsense and get a firm date off them for agreeing and starting your Mum's care plan, offer to come in at short notice if they have any cancellations.

I worked for decades for the NHS, it has its strengths and weaknesses but sometimes people need to be reminded of the trauma patients and their families are going though. Everyone likes to feel they are making a difference in what can feel like a faceless

Good luck!

Dave