Good evening everyone,
Got a call from dad's doctor last night
She says she wanted to talk to because of the following
Dad's lungs cancer has met to brain and liver.
The CT scan just shows the chemo is not helping.
tumor on liver has increased
tumor on lungs has increased in one lung and the other is lung remain unchanged
they are to access the brain tumor next, know chemo might not help because of blood/brain barrier.
the pleural fluid effusion in both lungs though draining through cauterization it is not doing well.
Her main concern was " starting talking about death and the option of not
going through another set of chemo again because it might not be worth it. Choose quality vs quality of life
My dad is still very much in denial stage. He is very positive. How can I approach this
discussion without making him think i am giving up on him?
Reply # - June 2, 2013, 01:19 PM
Reply To: Got A call from Dad's doctor
That's a tough question we face as oncologists all too often. I might suggest having the oncologist take the lead and then ask the oncologist about the probability or improbability of a benefit from more treatment. It sounds like further treatment is quite unlikely to be beneficial, I'm sorry to say -- though I think that's what you're inferring from the oncologist's comments as well. If the oncologist is guiding toward a recommendation against more active treatment and favoring a shift to a focus on comfort, maximizing support, and minimizing symptoms, then having you serve a role of ratifying that absolves you of a concern that you're "giving up on" your father -- you're just acknowledging the reality and the thoughtful judgment of the oncologist who is trying to not pursue futile, potentially just toxic interventions. I think it'll be a lot easier if you aren't the one guiding things: it's perfectly appropriate, and arguably ideal, to have the oncologist direct this discussion and you play a supporting role, since she should have the experience and insight to make the thoughtful suggestions you'd only be following.
Good luck.
-Dr. West
Reply # - June 2, 2013, 01:33 PM
Reply To: Got A call from Dad's doctor
Thanks Dr. West, Words can not explain how much your advice means to me.