My dear friend is a 43 yr. white, gay male that has cancer. He has tried to stick his head in the sand for a long time, refusing to find out if he was HIV +, but finally went to doctor in October 02 because of a spot on his collar bone that wouldn't heal. They found some other spots. They removed the one on his chest area but said it had gone down through the bottom margin. They wanted to do breast surgery and he wouldn't do it. I am not sure of the specific cancer, but he told me today that the nodes were growing. He is not on any medications at all, and I don't think has taken many before. He has exhausted his health insurance and says he can't afford any more meds. He never told the doctor he was gay even. My question is this: over the last month, he has gotten very sick. He has lost about 35+ pounds and weighs about 135 now (he's 5'10"), he can't eat hardly anything because he has severe diarhrea or has been throwing up (last 2 weeks)and this last week, he can hardly breathe and is coughing , plus he is very weak, he can barely climb the stairs. I fear he has pnuemonia. He has tried to keep this guise up to work but missed most of last week for the first time, I can't imagine what happens Monday. I saw him today and he is really sick, plus he had been drinking. I don't know much about aids symptoms or cancer stages, but from what I have described, does this sound like he has little time left? Is there anything I can get for him (OTC) that would help ease the diarrhea or vomiting so he can eat something? I'm very worried, he has no family and few friends. Thank you for giving me any information you can.

As you can imagine, your query is both moving and sad. A whole bunch of things needs to happen to your friend and they need to happen relatively quickly. Unfortunately nothing can occur until your friend wishes to seek care. Does he have a social worker? Most hospitals have a mechanism to treat uninsured or under-insured patients. Most HIV programs or cancer units have resource workers/social workers who can help patients, friends, and families access such programs. Your friend needs to be fully brought into the health care system. He desparately needs to be HIV tested. He may need to go out on disability while all this is being sorted out. Does his company have a disability program? I hope he addresses his illness, since many of my patients at one type were in his shoes. They found out what they had, got treated, and are now back at work. I am in no position to comment about specific types of treatment for him without knowing more about his diagnosis. Good luck.