How can we make the correct decision? I feel we are being sold on this by the oncologist and radiologist. When I voice my concerns about his quality of life vs. quatity he may "add on", I just get the answer "well, if the side effects get too bad we will just stop". Meanwhile, he lives at home with my stepmom who sees the same oncologist for Multiple Myeloma. How do we make this decision?
Those who recommend the chemo and the radiation will tell you they aren't going for cure, but for more time, and for "shrinking" this or that.
For myself, I would ask your father what he wants to do. If he is unable to make the decision I would call in hospice. For you, how you make the decision is by talking with your own family and doing the best you can. There is no one I think with an ounce of brains who would judge you WHATEVER decision you make. I wish you luck.As an ex RN at age 79 I would no longer treat any cancer save for blockages, et al, and would ask for the "good drugs". I have had a wonderful and very lucky life; I am ready enough. I am a 35 year survivor of breast cancer. Even with that knowledge I long ago stopped mammograms. Death comes to us all. The manner of death is important to me to have some say in, given what I have seen in my career.
Get a second opinion, see a different doctor. There are other treatments.
Go online and view a few Youtube videos by Dr. Atul Gawande. He speaks wisely and compassionately about quality of life, end of life, and hospice.
I can't imagine a 90+ year old person going thru the same difficulties. Sending you a big hug because you are in an untenable position.
Chemo/radiation treatments on a very old sick man will make him feel so horrible that he will wish he could die.
We all have to die. Let him spend his remaining days and months in comfort.
Ask the oncologist:
a) what are we hoping to achieve?
b) what is the 1, 3 and 5 year survival rate of comparable patients? - that is, patients at this stage of the disease undergoing this recommended treatment, regardless of the patient's age. The oncologist must be able to look you in the eye, tell you it's 15% (or whatever), and still make his recommendation ethically defensible. Maybe he can, I don't know.
Then, whose decision is this? If it's your father's, then the oncologist must be prepared to be as explicit with him about the risks and potential benefits as he is with you. Informed consent depends just as much on full information as it does on the patient's (or proxy's) consent.
If your father still wants to go ahead, support him; but make sure that he has face-saving opportunities to back out at strategic intervals.
My friend’s mom decided not to do anything about her lung cancer in her late 60’s. I found it interesting that she lived longer than others who went through treatment.
She saw all of her children marry and have children. She had lost her husband many years earlier in an automobile accident. He died when my friend was 8 years old.
She was at peace with dying. She didn’t care to endure the misery of treatment for an extension on her life. Her children supported her choice not to treat her cancer.
Who really knows what the motive is behind a doctor who offers this kind of treatment to an elderly man? My mom’s doctor told her when she was in her 90’s that she would never recommend any form of life prolonging treatment or surgery if she needed it. So, not all docs are money hungry.
My friend switched law careers mid stream. He was a successful criminal prosecutor. He went into malpractice law, defending doctors, saying that he would earn tons more money! He did! He has a gorgeous home, fancy cars and travels the world. Kind of says it all, doesn’t it?
We have to be careful when we choose our doctors. There are good and bad examples in all walks of life.
When I was first dxed, I was 62. Did about 15 months of tx and finally, just so sick of being sick, I quit. I had done not just the 'protocol' chemo, but 6 rounds of FU tx also.
Even though it's only been 2 years, a LOT of leftover side effects have made my life about 60% of what it was and I am as 'good as I'm going to get'.
Drs will give you stats and numbers and of course, their job is to get you in remission---but a LOT of the time, they do not look at the patient's age, family dynamic, etc. They simply see a problem they can 'fix' and BTW, the surgeons will not be the ones who follow up. It will be an oncologist. I saw my surgeon TWICE and never again, b/c there was nothing else for him to do.
I'll see my oncologist for the rest of my life. And HE is respectful and honest with me. He also agrees--go see a surgeon and you will likely be a 'candidate', somehow, for surgery.
At 93--why torture your poor dad?
With your Dads age, not sure if I would put him through all he needs to be put thru. Radiation burns the skin. His skin has already thinned out. These doctors should be giving you the worst case scenario. When they said the word "study", I would have said no. At 93 your Dad does not need to be a Guinea pig.
My sister was in a study for a very aggressive cancer. There had not been any survivors past 3 yrs on the drug she was given. She went thru 8 months of chemo where she couldn't even work because she was sick from the chemo. She was done in June, went back to work in July, started having pains in her back in Sept and died in Oct. Her breast cancer had gone to her spinal cord and to her brain. Now, how long would she have lived without the chemo? FIL had lung Cancer at 68. Part of a lung removed and chemo. 3 yrs later it came back. Chemo again but he died at 71. My Aunt, lung cancer and even with chemo died at 79. Her brother, lung cancer died at 60 even with chemo.
I have seen what chemo can do. At 93 I personally would not consider it. Since ur Dad is cognitive, it will be his decision. If he says no, go along with that decision. And yes, Cancer is a money maker. I really am surprised that these Drs are not considering his age.
So, not to make this about ME and my dad, I think cancer is a much scarier diagnosis. I watched my mother try everything to live and the chemo was horrible. When I myself was dx'd with breast cancer at 63 and recommended lumpectomy and chemo, I said no... cut them off. I do not want chemo under ANY circumstance. Of course, when faced with the actual decision, who knows?
How has his health been otherwise? Does he have any other comorbidities? Is your step mother capable of taking care of him and bringing him to all these chemo sessions? So much factors into this decision.
The one thing that helped was when a doctor told my sister that there is no RIGHT decision and whatever decision you make you need to stop second guessing yourself and go with it. I still wonder if I prolonged his dying but I feel like we gave him the chance he would have wanted.
So sorry for your family to go through this.
When I asked what was the prognosis with treatment. He boldly said she will have roughly 8 weeks. Seriously? You would put her through chemo for 8 weeks? Yep, without hesitation.
She lived for 7 weeks with no treatment once she went home on hospice. She was in the hospital for a couple of weeks, so she had 1 additional week and they were all on her terms. No puking her guts out, loosing all of her hair, no being utterly miserable every minute.
I think that there is something very wrong with any doctor that doesn't consider the fall out of pumping a fragile body full of poison. This is western medicine at it's core, filthy rotten!
To each his own but, I would do some research on what chemo does to the human body. Radiation is a whole different bag of ugly.
Hugs...
If your dad isn't 100% in charge and competent enough to make this decision, I believe you have an obligation to protect him from any treatment that doesn't contribute to his quality of life.
Doctors feel obliged to give you all the possible treatment ideas, but too many of them won't tell you whether it's a good idea to actually do them, nor will they answer the question, "Would you do this to your father?"
I'll give you my story -- My aunt was diagnosed with multiple myeloma and was clearly pretty far along once she was diagnosed. Her children couldn't bear the idea that their vibrant, active 90-year-old mother could possible die, convinced her to do chemo. She did about two weeks' worth, was violently ill the entire time, and died a month later anyway. She was the one who put an end to the chemo, and now her children kick themselves for robbing her of two precious weeks of relatively good health because THEY couldn't bear for her to die.
Please try to think about what's best for your dad, not what you think is best for you. That's the most important thing to take into account. Is chemo and radiation going to cure him? Probably not, so why poison and burn him?
Mom asked the drs how long she would live without the surgery and was told 2 years. Well, she decided to have the surgery, rehab, recovery and a steep decline into dementia. She lived another 2 years. So we might have had her for 2 years and cogent instead of 2 years not recognizing anyone. I wish now I had talked her out of it.
How to understand those docs? $$$$$$$$$$$$$
2 of my kids are Drs. Both are overworked (NOT underpaid, I'll admit) but they are totally devoted to their 'callings'. They give patients all the options and outcomes. It would be almost malpractice to not offer all treatments. And people have a right to refuse or ask for 2nd, 3rd opinions.
Neither takes kickbacks from Big Pharma, neither are pushed by their hospitals to do unnecessary txs.
I see how hard they work and how much they are and I know they are the 'rule', not the exception.
They are always there to offer hope. Just my view on seeing them in action.
My question is what are we extending his life for and how long do we expect him to live a quality life. Maybe the question to his Docs should be "If this were your parent what would you do?"
If it were my mother, I'd ask what she wanted and try and go by that, knowing my mother it would be to let nature take it's course. However, I think dad would be better off looking into hospice where they can will care for him without active treatment of the cancer. They can provide pain meds and other treatments to keep him comfortable and lead and end with quality of life with dignity.
The doc is correct, if it is too much treatment can always be stopped - but before pursuing this option, first look into the side effect on a 93 yo body.
She celebrated her 100th Birthday at the end of December, is doing well and is still home with me.
if your dad is mentally competent, this choice should be left purely to him, and you should support his decision.
This is a complicated medical issue that has lots of variables. Surely they are considering his age, mental status, overall comfort and potential outcomes in recommending treatment.
If you think their medical advice is not appropriate, seek another opinion from a qualified medical provider, not advice from strangers in a chat room.
"In stage IV lung cancer, chemotherapy is typically the main treatment. In stage IV patients, radiation is used only for palliation of symptoms. The chemotherapy treatment plan for lung cancer often consists of a combination of drugs."
https://www.lungcancer.org
Feeling tired and weak is the normal state for most 93 year old elderly. Given that this 93 y.o. gentleman has cancer of the lungs, I am sure he's feeling a lot worse than tired and weak. If he goes through the gruesome chemotherapy and radiation treatments, they would leave him feeling half dead and wish that he already was.