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Colon Cancer/86 year old father

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Question
Hello,

My father is 86 years old and suffers from dementia. He recognizes his family members, but is in a state of constant condusion about where he is, what is happeneing, etc.  His quality of life is very low because of the dementia.  

He was recently hospitalized for pneumonia.  While there, they found kidney trouble, weakened heart with an irregular heart beat, and colon cancer.  After 9 days, he has recovered from the non-cancer issues and is being discharged to a rehabilitation facility today for physical therapy and to rebuild muscle strength.

While in the hospital, he became very depressed, agitated, and desperately wanted to leave.  It was heart breaking to see him like this.  He kept trying to remove tubes and get out of bed, so he had to be watched 24/7.

The oncologist and internist are recommending surgery to remove the 4cm by 3 cm tumor in the colon.  An alternative would be a combination of chemo and radiation.   The mass is not obstructing anything.  The cancer has not spread to other organs or areas.  They completed a colonoscopy, a CT scan, and a biopsy.

Considering his overall condition, my siblings and I are considering whether he should have any cancer treatment at all, because our concern is the treatment may kill him, or make him so miserable it is not worthwhile.  

We asked the doctors what would happen if we chose to NOT treat the cancer, and how long he might live, and what his quality of life would be.  They refused to provide an estimate, and said they would not know until they removed the tumor.  I am wondering if the doctors' response is reasonable?  When I have heard of others diagnosed with cancer, it seems the doctors are usually able to provide a life expectancy estimate.

Thanks for your help.

Answer
I understand your dilemma. Your father's situation with dementia, confusion and other issues and on top of it a colon cancer causes this problem. His cancer is not causing an obstruction now but if nothing is done it will grow and eventually cause an obstruction! That will further deteriorate his condition and will make it harder to operate then! So if something should be done - and in my opinion it should since the alternative is worse for your father - it should be done now before he gets worse. I have to side with his doctors. It is hard or even impossible to predict how long it will take with any precision.  Without a full pathology report of his cancer - can only be obtained by the suggested surgery - it is even harder! Cancers in old people sometimes grow very slowly but even that can not be evaluated without that pathology report! If his cancer turns out to be a lowly differentiated fast growing tumor it will grow fast in spite of his age. We can not know with any certainty without that report. So my advice to you must be to follow the advice of his doctors! Without the needed information I have described they can not evaluate his situation. The cases you refer to are most probably cases where all the needed information was known. But even then predictions are very uncertain.



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Colon Cancer

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Claes-Gustaf Nordquist, M.D.

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I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience with regards to this cancer.

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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 I have no restrictions on the number of questions there.

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