SCLC & questions for doctor - 1256060

pattys
Posts:14

My husband has metastic lung cancer with the new site being the brain. He has had WBR and radiosurgery. How do you ask the doctor how long he has without using those words? Will he likely give us an answer? Is it appropriate to inquire about hospice or do doctors tell the patient when it is time?

Thank you. Patty

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Dr West
Posts: 4735

Patty,

I'm sorry to hear of your husband's diagnosis. Though you can find some general stats for populations on this website and some others, it's worth remembering that statistics are very good for telling how a population of people will do but are not helpful in telling how an individual will do. Nobody really has a good answer in advance, despite the dialogue of bad TV movies about how long someone has to live, but experienced clinicians often have some idea. It's fair to ask something pretty direct, such as "can you give us an idea of how long he might have?".

As for hospice, it's worth mentioning that you'd like to know when it would be appropriate to be thinking about hospice. It's a great blessing at the right time in a person's course with an incurable cancer, but some oncologists are extremely reluctant to broach the topic, either because they themselves aren't comfortable with it or because they presume that the patient will feel alienated by it being suggested. Mentioning it and conveying that you would be receptive when the time is right could really help convey to the oncologist that you are inclined to pursue more aggressive treatment when that's indicated, but then that it makes sense to shift to hospice when anti-cancer treatments are more likely to cause harm than benefit.

Good luck.

-Dr. West

certain spring
Posts: 762

I just wanted to offer some words of support, as I know your husband has been through a lot, and it must be very hard for you to be thinking about what's coming next. For what it's worth I think it is both sensible and brave to be asking these kinds of questions. My experience is that doctors cope best with direct questions (as Dr West describes), and that really good doctors take their cue from the patient and their family. When I was diagnosed there was always a moment when the respiratory physician would say, "Do you have any other questions?" I think in retrospect he was trying to create a space for me (or my husband) to ask about life expectancy if we wanted to.
I hope that you and your husband are able to have many happy moments together before the disease takes him from you.

pattys
Posts: 14

Dr. West - Thank you for your reply. I got the courage and used your words to ask the question. Our doctor was wonderful and spent an hour with us discussing my husband's history since he was diagnosed in 2011 to the present. His answer is hard to accommodate in our hearts and minds, but it is what it is and we must make this journey. I did not bring up hospice at this time because I could tell my husband had as much as he could take for that visit.

Certain Spring-Thank you also for your comments. I bet you are right about the "do you have any more questions" ending to appointments. I guess it allows the patient to have some control over what they are able to handle at the time.

certain spring
Posts: 762

Well done - Lord knows it isn't easy. Hope that it helps you plan a bit. I think you were very wise to stop when you did - it's absolutely right that there's a limit to what one can take in at a time. I have a kind of "cut-out" mechanism that comes into play: I hear what they're saying, but at a certain point I no longer absorb it.
Best of luck to your husband and to you.