Will cancer treatment help at this point?

Elizabeth76 asked...

My father was diagnosed with stage four renal cell carcinoma ten months ago. Last February he had a radical nephrectomy. Soon after the doctors found that he had small tumors on his liver and lungs. Shortly after that they found it on his arm in the bone. He started a chemo treatment in July that made him terribly sick. He stopped the treatment and remained in poor health. He was sleeping all of the time, very weak, no appetite and always in pain. He started radiation for his arm a little over a month ago, to ease the pain and to try to shrink the tumor so his arm wouldn't break. His last attempt at chemo did not stop or minimize the cancer in his organs. The grew quicker and larger instead. He was going to try another chemo therapy this coming Monday, but he went in to respiratory distress at his radiation treatment and he had to be admitted in to the hopsital. He is extremely jaundice, his ultrasound showed that his liver is full of tumors and even a stint could not relieve any blockage. He is in renal failure and liver failure I believe.

My mother and I never see the doctors in the hospital and never get to talk to them on the phone. His nurse told me that he is a full code patient and with that they could not release him to go home to die. A covering doctor told my mom that if he is receiving any kind of treatment to cure the cancer, like chemo, that he can not have hospice. My mother thinks that he is still going to receive chemo on Monday. Is there any point for him to do this?

I love my Father terribly and can not bear to see him suffer anymore like this. Can chemo at this point help at all??? I need to know right away.

Expert Answer

Linda Ackerman, R.N. has clinical experience in oncology, women's health, and medical nursing. She has been practicing for more than 20 years and is a licensed registered nurse in both Florida and Wisconsin. In addition, she serves as a board member of Breast Cancer Recovery and the Wisconsin Cancer Council.

Based on your description of your father, chemotherapy may sometimes help in what is considered palliative treatment, where the chemotherapy may help slow down some of the rapid cancer growth you have described. The chemotherapy does sometimes help control pain. However, chemotherapy does come with many side effects as you have noted in your question. The choice of additional chemotherapy would be better directed by your father if he is able to make decisions. If he is unable to make decisions, a signed power of attorney for health care document is the best source of information which allows a family member to make medical decisions on behalf of your father. I would suggest requesting an immediate family meeting to be held with the physician who knows your father's condition the best, the nurse who you primary speak to, a staff person from the local hospice organization and a social worker. Based on your question, you, your mother and father need additional first hand information to be able to make well informed decisions on whether or not to seek additional chemotherapy treatment and or additional medication to help alleviate his pain. Each hospice organization has different criteria when accepting patients into their service. Some hospice services do allow a person to undergo palliative chemotherapy to help alleviate any pain issues and others do not. I would recommend you and your family review this specific hospice agencies policy regarding receiving cancer treatment.