Question My 80 year old father in law was just diagnosed with localized ring cell colon cancer. It is aggressive form, but localized according to PET scan. He is terrified of surgery as he has had two pretty major strokes in the past year and still suffers from aphasia. What type of medical experts could best predict his risk of stroke during or after surgery? Can they even semi-reliably give him some odds of survival? At this point is he wanting to opt out of surgery and just check into hospice to "wait to die". But localized cancer should be "easy" fix for surgery if he doesn't have a stroke. He currently takes Coumadin - I know there are different meds better suited to take during surgery to lessen risk of bleeding out but still maintaining some stroke prevention effect. Thanks!
Answer Dear Julie,
If it were my father, I would have him seen by a vascular specialist. They should be seeing him anyway, so that they can do scans on his veins and arteries to see if there are any conditions that should be treated.
There are surgeons that specialize in vascular surgery and they sometimes have their own labs for diagnostic testing in their offices. These doctors are ones that I would have my family visit.
You are correct in that he should also be seen by the doctor prescribing the Coumadin prior to committing to surgery. The reason for this is that this doctor will spell out the plan of how and when your father will take any medications for blood thinning related to surgery. The rationale for seeing this doctor is exactly as you said, to reduce the risks associated with complications from blood clots and surgery.
As far as your father wanting to opt out of the whole surgical experience...funny thing, is that my father would probably say the same. You cannot force him to have surgery but you can make sure he has all the choices that are available to him, given to him.
What I would do next is to provide them all as best I could. Get second opinions about the cancer. Have him seen by a vascular specialist. Look into aftercare. Look into hospice. Have all the choices and sit down together as a family and decide the course of action you will choose. When this type of illness occurs and the family is involved in the plans and care of the loved one, the outcome no matter which choice is made, is one that everyone can take part in and feel satisfied that they all cooperated and mattered.
