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Medical Forum / Diseases and Disorders / Cancer / January 2006Looking for advice on what to do for stage 4 cancer victim
Hello all, My stepfather was recently diagnosed with stage 4 cancer, its in the bone but they have not identified the source. His care has been limited to one doctor - one medical facility. I have been trying th encourage the family to seek alternative therapies, second opinions and specialists. The family - including the victim - have been reluctant to do anything. Do I just stand by and watch while this man dies? Am I taking the wrong path in suggesting that other resrouces be called into this battle. Please advise with any comments/suggestions. Thanks Derek.- > Hello all, > [quoted text clipped - 10 lines] > > Derek.- It is very likely that the advice they have had is the same they would get from any competent doctor although they are certainly entitled to a second opinion if they want one. However I would caution about 'doctor shopping'. If you are persistent you will always find a doctor somewhere who will do 'something' but this may not be in the patient's best interest. As for alternative treatments, well, just read enough posts on this ng and you will find quite a few people willing to take your money in exchange for useless potions. The best that can be said is that some of them mean well. There are even a few qualified medical practitioners offering 'snake oil'. Ask your oncologist before being tempted to sign up with them. MIKE > Hello all, > [quoted text clipped - 10 lines] > > Derek.- What's his age and general condition? What symptoms?? For the vast majority of people with the common cancers and widely metastatic disease, treatment cannot cure, or prolong life, so the only reason to treat is to improve quality of life. To decide is this is correct, you need to be sure that any symptoms he has will be helped by treatment, and any side effects would be minimal. Multiple second opinions and (especially) chasing the rainbow of alternatives is just wasting what time he has left. You need to discuss the situation with his oncologist. > My stepfather was recently diagnosed with stage 4 cancer, its in the bone > but they have not identified the source. His care has been limited to one [quoted text clipped - 4 lines] > suggesting that other resrouces be called into this battle. Please advise > with any comments/suggestions. Hello Derek, I'm sorry to hear about your stepfather. Anything else to go on? What prompted the diagnosis? An annual exam? Pain complaints? age? race? blood levels of CEA or PSA (very elevated) ? family cancer history? signs? (would be visible things - bleeding, weight loss, yellowing of skin ) symptoms? pain in certain non-bone locations, vomiting or upper or lower digestive woes? Previous skin cancer surgery? We can't diagnose here, obviously, but sometimes clues can say what might be likely. On the other hand (just an example), if it was an 87 year old , like my grandfather, who might have an elevated PSA, might choose to die with a slow-growing cancer as opposed to treating it aggressively and affecting quality of life OR might try to slow it down with hromone treatment, but there's side effects and there's no point if nothing points to prostate cancer. I assume they asked these questions, but if you, he or family think of anything that wsn't mentioned at the time, might be worth mentioning. Searching for a primary cancer can be invasive and require many tests and sometimes cause more harm than good, but if you think of anything, let us or them know. J >> My stepfather was recently diagnosed with stage 4 cancer, its in the bone >> but they have not identified the source. His care has been limited to one [quoted text clipped - 33 lines] > them know. > J The man is in his late 60's. He complained about a back ache after playing golf. No other symptoms. Doctor put him on pain medicatio and treated it like a muscle problem. After about a month of that style of treatment and massage therapy etc - He want back to the doctors and they did an MRI, Cat Scan. They saw grothws on his spine, a very small spot on a Kidney but that was about it. After a biopsy it was determined that they mere malignent. They took a sample from the pelvic bone and the cancer had spread to there. He was in great pain. It was diagnosed as stage four cancer. They gave him pain medication and started radiation therapy. Still no localization of the root cause. After two weeks on radiation therapy the pain subsided a bit. He became very weak, dehydrated and was admitted to the hospital. The man is now maybe 150lbs. Has an infection in his throat and the doctors prognosis is not very good. He has a hard time eating and is sensative to touch. The did cat scan of the brain and found that nothing had spread there. I don't know what the next step of the treatment is if there is any. A friend of the family is a homeopathic doctor - I thought about trying to coordinate a visit - Or maybe one of the local speciallty cancer centers (Detroit Area). What's reallyu weird is that prior to the gold incident - there were no symptoms - nothing at all. Open to ideas and suggestions. Thanks Derek.- > The man is in his late 60's. He complained about a back ache after playing > golf. No other symptoms. Doctor put him on pain medicatio and treated it [quoted text clipped - 17 lines] > What's reallyu weird is that prior to the gold incident - there were no > symptoms - nothing at all. I think I'll wait for Steph's impression, Kevin. If it's a thrush infection, he needs nystatin or miconazole. I don't know about miconazole, but nystatin comes in a liquid that can be swished, gargled and swallowed, several times a day, to work on the fungal infection (and relieve swallowing problems) It says here http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_Is_bone_metastasis_66.asp that "Breast, prostate, lung, kidney and thyroid cancers are most likely to spread to bones. " Back later, J. Providing for Quality of Life in thie case seems the best option. This webpage from the University of Michigan is very informative: http://www.cancer.med.umich.edu/learn/bonetreat.htm > If it's a thrush infection, he needs nystatin or miconazole. > I don't know about miconazole, but nystatin comes in a liquid that can be swished, > gargled and swallowed, several times a day, to work on the fungal infection (and > relieve swallowing problems) My doc gave me 10 mg clotrimazole troches to dissolve on my tongue.  SignatureIf John McCain gets the 2008 Republican Presidential nomination, my vote for President will be a write-in for Jiang Zemin. > >> My stepfather was recently diagnosed with stage 4 cancer, its in the bone > >> but they have not identified the source. His care has been limited to one [quoted text clipped - 22 lines] > What's reallyu weird is that prior to the gold incident - there were no > symptoms - nothing at all. Hello Derek, If you're still out there reading. There have been a number of times when loved ones have showed up here where the cancer was so advanced that nothing could be done, but palliation. One sister from Quebec comes to mind. They had no idea her father had cancer, just a backache. Then he fell and fractured his spine and he passed away, if I recall correctly, within weeks to a month. Mom was diagnosed with lung cancer (advanced) ~5 weeks before she died. There really was nothing to be done but stand by and keep her out of pain. I see that Steph hasn't replied and I've wracked my brain as to which type of cancer he might have. Nothing stands out. With CUP (cancer of unknow primary) the prognosis is grim, especially advanced the way your stepfather's seems to be. I think we know that in advanced cases one or more of the following can occur and sometimes result in death within weeks: Epidural Spinal Cord Compression, Plexopathies, Leptomeningeal Metastases, Paraneoplastic Disorders. Once the spine is involved and/or sometimes, in advanced cancers, the cancer can be in thr brain but small cells (micromets) that cannot be seen on scans. One of our favorite posters here, was doing well on chemo, but he too had advanced cancer and one day he ended up in hospital. He thought he'd be out shortly, but died of a brain hemorrhage within days. Really, if they've found nothing enlightening yet, then compassionate care would be the wise thing to do and that would involve treating his symptoms (such as pain) and possibly not hydrating him and letting him go, sadly. It's difficult, I know, we had to standby and let my Dad go. If he's awake, alert, hungry, feed him, hydrate him, treat him for pain, love him until the body no longer wants any of that. He can be kept in hospital (hospice wing) or at home, if there's enough family members to care for him with the assistance of home hospice. Let us know if there's new findings or if we can be here for you. My thoughts are with you, your stepfather and all your loved ones. J >> >> My stepfather was recently diagnosed with stage 4 cancer, its in the >> >> bone [quoted text clipped - 50 lines] > of > cancer he might have. In a 60 year old man with metastatic cancer of unknown primary, a diligent search for the primary will be unsuccessful in about 15% of patients, and it may be pointless in any case. In adult males, 80% of CUP is caused by the following cancers, in this order: lung, prostate, gastrointestinal tract. Derek, I don't come here enough to know your details. But is he at the Univ of Michigan? My sis is there getting specialized treatment for her cancer. I urge you to talk to him directly; ask him if you can help him in anyway...if possible, call someone at the U of M...and/or hospice people. They can give information, even if it is not the right time for them to give assistance. I feel for you; please reply if you have time. Aprilolaw at yhoo > In a 60 year old man with metastatic cancer of unknown primary, a diligent > search for the primary will be unsuccessful in about 15% of patients, and it > may be pointless in any case. > In adult males, 80% of CUP is caused by the following cancers, in this > order: lung, prostate, gastrointestinal tract. I wonder if it could be prostate and if so, does hormone therapy help with the bone, does it help prevent spread to other organs and thereby prolong life? This (recent) article seems to be indicating that there's 3 types of prostate cancer http://www.cancer-therapy.org/volume3_2005/42_Daneshmand/42._Daneshmand.pdf 1) the garden variety 2) mixed (the garden variety and small cell) 3) small cell, which is treated with chemo only. If I read that right, the small cell is undetectable the usual ways (PSA and DRE) because it attacks the lining of the prostate ("arise in the periphery of the prostate gland") instead of forming a mass (lump that can be felt) which leans me to thinking that a slight thickening could be misattributed to something benign.. If so, wouldn't it be worth a shot at hormone therapy (for this person's father)? Wondering about this poster's father and also there might be someone lurking, from the prostate cancer newsgroup, who has been diagnosed with small cell prostate. So I have more questions, if you'd read it and humor me, please. J |
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