Expert: Claes-Gustaf Nordquist, M.D. - 1/3/2007

Question
My father-in-law lives about 6 1/2 hours away from us and was diagnosed with Stage 4 Colon Cancer in September 2005. He has since been on chemo and radiation but seems to be getting worse. My purpose in writing to you today is to get more clarification on things. My husband's relationship with his dad's wife is extremely strained and we get very little information about his condition. My father-in-law tends to not tell my husband everything so not to worry him. And of course because of HIPPAA regulations we just can't call up the doctor anymore because my father-in-law's wife removed my husband's name from the HIPPAA form several months ago. And we don't wish to bring the subject up with my father-in-law because we believe the bigger picture here is how he's doing and we'd rather be able to get whatever little information we can from her instead of nothing. Here's what we know:
1) his last cancer cell out was 261
2) he is now jaundiced
3) the tumors in his lungs are making it hard to breathe so he is using an inhaler to help
4) he is on oxygen
5) he uses a wheel chair to help him get around when he leaves his house
6) a knot has developed around his colostomy bag
7) he is bleeding rectally again - we are unsure if this area was permanantly closed when the colostomy bag was inserted
8) we are under the impression that he is also starting to spit up blood
9) His current oncologist has been fired by my father-in-law's wife and they are going to a cancer center in Houston where many tests will be run and determine if anything can be done to help prolong his life?

My question to you is this: My husband and sister-in-law feel like their dad is being forced into treatment that he doesn't want. He's made the comment several times to my husband that he is tired of going through all of this. After reading the information about his condition, is it your opinion that maybe at this point he just needs to be made comfortable?


Answer
Well I can recognize a losing battle when I see one and this unfortunately is one. He evidently do not have much time left so even the MD Anderson Cancer Center (I suppose that is where he is going) can not do much! If I were in his shoes I would probably just want to be left in peace or I would put my gun in my mouth (yes I would). How you are going to solve this communication problem I do not know but you have to expect him passing away within weeks - or shorter with complications - or in maximum survival time within a few months.