Re: need advice on my father's lung cancer

J W wrote:

My 73 year old father who has emphasyma and refuses to go to doctors
unless he is in agony had a fall recently which fractured a rib and
forced him to go get xrays. They found what they termed a very large
mass in his lung. They at first told him that the entire lung would have
to come out. After they did a bronch scope & biopsy they now tell him
that he is too old and weak for the lung removal or chemo and have
instead recommended he start radiation treatments for it. He had colon
and stomach cancer 30 years ago so I suspect this is a slow growing met
from that but I don't know how one would verify that or if it would
matter. I now have stage 4 colon cancer as well so it appears "like
father, like son". He asked me if I would take the radiation given his
age and condition. My knee jerk reaction because one naturaly does not
want to resign ones own flesh and blood to death was to say yes,
anything that may help is worth trying but after thinking it over I'm
not sure that was the best advice. I have read that radiation does very
little good in advanced lung cancer and has some potentialy wicked side
effects.. They have not told him yet what kind of cancer it is though
I'm not sure it would matter since it is such large mass. I'm thinking
now that if the radiation has little chance of prolonging life or
curing, given the side effects and his physical condition. Would it be
adviseable for him to take it or would he be better off quality of life
wise to just deal with it as is. He really put me on the spot asking me
if he should take it because whichever answer I give him, if he dies I
will feel responsible. Your thoughts?

I'm sorry to hear about your father.
If they've done a biopsy, they'll know which type of lung cancer he has.
Some types of lung cancer are faster moving than others. There's also
sarcoma-type lung tumors. So ask for the information.

Before contemplating any treatment, a person should ask if he's had scans
and if they know if it has spread elsewhere. The location(s) of emphysema
can also be seen on scan and a lung function test can be done.
Radiotherapy would not cure nor prolong his life. (unless a tumor was
risking pressing on a vital blood vessel to his brain or heart), in my
non-expert opinion. Judicious radiotherapy might help shrink the tumor and
help him to breathe and/or help him with swallowing issues if it starts
pressing on his esophagus, thereby allowing him to continue to eat. The
location has to be discussed with the experts and if unsure, seek a 2nd
opiinion, but do make sure that it will be "judicious" radiotherapy
Radiotherapy can help with bone mets to palliate bone pain.

Pull all these pieces together and discuss the pros and cons with his family
doctor (who should know his co-morbidities or have an opinion). If you all
agree that it's best to seek help from hospice, a primary care practitioner
should be able to refer you to one who will help (at home, or an
institution) to keep him comfortable for the rest of his life.

The "medics" can sometimes keep a person alive for quite a while, but in
hospital. Only your father can make that decision, once he knows all the
facts and the choices.

I'm not a medic.
Best wishes with your decisions.
J

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