No Treatment?

Thank you Joyce and Rita. We talked to the Oncologist. He told us that my husband is much to weak to receive Chemo right now. He needs to build up his strength. Reason for starting chemo now when they didn’t at first diagnosis is since the tumor has spread they need to stop the growth from invading the liver. However, he is struggling to get over the latest surgery. Very weak, no appetite, lots of pain. He ate a small portion of supper last night, but in the night he threw it up. Now I am wondering if the surgery was successful. The surgery was to create an alternative opening for the food to be extracted from the stomach. Before he had the surgery and was vomiting every meal we were told that was because the food had no where to drain. I’ll keep you in my prayers.

Hi Rita,
I know how frustrated and powerless you must feel – especially since they can’t even give you an exact diagnosis. And he has so many other health issues, it must be so scary for you. The only little bit of info I have for you is that the urine is usually very dark/brown/tea colored with cc – my mother’s was like that for the last 2 months of her life, very shocking to see but it’s just the bile getting re-routed to the urine when the liver isn’t functioning properly (I think that’s the medical explanation).

I hope you can keep his pain and his blood sugar under control – if he’s not eating, you may just have to let him be, try to give him liquids frequently, but he may not be eating because of depression, too, so maybe he could see a clergy member or psychologist at the hospital? He sounds like the type that wouldn’t go for that stuff, but I thought I’d suggest it just in case.

Truly, your being there for him is the greatest gift you’re giving him. He appreciates it, whether he tells you or not.

Best of luck and hope,
Joyce

Dear Irene,
Your message may get lost here where it’s posted, you may want to copy and paste it into “introductions” so more people can see it and respond.

I’m so sorry you and your husband are going through this terrible ordeal. It’s wonderful that he’s managed to beat the odds so far with all of his other medical problems. I’m very confused as to why they would want to start chemo now that everything has spread more – I would think chemo would be out of the question at this point, but hopefully you’ll find out more from the doctor. Chemo can be very debilitating so I’d ask what drugs they were planning on giving him – gemcitabine and Xeloda are the usual ones for cc, and they’re milder than most and don’t always cause hair loss, but they do usually cause nausea. It’s a tough decision and whatever you choose is right, but if the doctors don’t think he has much time, you may want to consider that chemo may worsen his quality of time he has left. It’s all up to the individual and some people tolerate it well, but my mother was too far along when she tried chemo and it really knocked her out and lowered her immune system.

Get all the answers you can possibly get from the oncologist and post back here so some of the knowledgeable people can give you their perspective. Unfortunately, there are so many perspectives that it may be confusing. You just have to follow your husband’s wishes and make him feel supported in whatever he chooses. I know what it’s like to have to care for someone who keeps it all inside, and it’s heartbreaking. The poor man must be feeling so much anguish that he can’t share. Can he talk to a clergy member or hospice worker, maybe? Sometimes it’s easier to open up to a stranger – he probably doesn’ t want to burden you with his worries because he loves you so much.

Much luck on your doctor’s appointment – I hope you both find some comfort and answers here-
Joyce

My husband Bob is 76 years of age. 14 months ago he was diagnosed with inconclusive bile duct cancer. Inconclusive because they were not able to do a biopsy. However all the signs pointed to BDC. He is not a candidate for surgery because of his age, plus he is diabetic and also has congestive heart failure. His heart operates at 30%. Two years ago he had a five vessel heart bypass. Then Sept. 2006 the bile duct report with a prognosis of 3-6 months. Depending on the Dr. the prognosis could be anything from 3-18 months. We went to the Mayo in AZ where they placed metal stents. Prior to the metal stents he had plastic stents. He had so many infections and was in and out of the hospital, twice suffering from septic shock and liver abcess. In Oct 2007 the metal stents became blocked and the Dr. used a balloon to dilate and enable the stents to become unclogged. One month later, (Nov.) he started vomiting. The Dr. did an ERCP and discovered his stomach was blocked. The bile duct tumor has spread to the stomach. He spent 10 days in the hospital while they drained his stomach of backed up food that had no exit. That took six days during which time he was not allowed any food or liquids. He could have ice chips. They did a bypass from the small intestine to the stomach. So now he has the bile duct draining into the stomach and the stomach draining into the intestine. So far he has received no chemo or radiation on the bile duct tumor.They told us it was pointless since stats show it is not successful. However, now with the stomach invaded we are told chemo and/or radiation can be available. We are scheduled for a consultation this coming Monday, Dec. 3. I am wondering if he has the strength to do this. He lost about 25 lbs in the hospital. He is very tired and said he feels so weak. The surgical abdominal incision has not healed yet and I have to clean and pack it with gauze every day. Would chemo be started under these circumstances? Yesterday was one of his awful days. Neither ate or drank anything and stayed in bed. Today is much better and he has been able to eat some small portions. My husband is a very private person and keeps a lot to himself, so he doesn’t discuss all of this only to let me know he feels terrible. I wish he would talk to me. I can only imagine how awful it must be for him to keep all his emotions inside. So far he has beat the 3 month prognosis but I am worried about the chemo. His Dr. told him the chemo would be the kind that does not cause nausea or hair loss. I guess I thought all chemo and radiation caused all kinds of miserable side effects. We will know more on Monday. Thank you for letting me ramble. God bless each and every one of you. I am so glad I happened to find this site.
Irene.

While this does not make the here and now any easier – know that you will make the right decision at the time it needs to be made. You will know what is right for your dad and your family.

As far as treatment for your dad goes, I encourage you to understand that Chemo is brutal on the healtiest of people and within days of beginning treatment your dad’s qaulity of like will drastically change. If dad is concerned that he is doing nothing – assure him that he is in being able to continue to share his life with his family.

Bz

Dear Rita…. It is difficult for anyone to tell you what direction to go. Have you gotten a second opinion? Maybe that would make your decision making a little easier. Considering your father’s age and medical conditions especially the weak kidneys and congestive heart condition, trying chemo probally would be highly risky. My Dad had and died from congestive heart failure. His arteries were so bad they would not even attempt by-pass surgery. I guess my point is chemo is very harsh and eat away at cells and connective tissuse and interefere with normal functioning of many organs and the doctors are most likely concerned with organ failure and /or internal bleeding. I am so sorry your Dad has been struck with this disease and unfortunately I can’t think of anything that would be of help to him. If everything is as you say it is, I would cherish every moment and provide your father with all the love and support you can muster. Rita I’m only 51 with I guess healthy kidneys and a heart that beats irregular because of the chemo. Surgery is no option for me either due to mets to the bones. I am still trying some chemo and radiation but the doctors are considering it as pallative treatment to try to extend my life. I’m not lost, I understand the reality but also understand that miracles happen every day. So I will end by saying there is always hope, but it’s your Father’s choice as far as getting a second opinion and treatments if the doctors are willing to do it. If they strongly feel it will shorten his life or cause greater problems they may not be willing to do. I hope I wasn’t to awfully blunt but I tell it like it is. Cancer is a cruel disease. A prayer of support is coming your way.
God Bless,
Jeff G.