Does it sound like my father with stage 4 cancer is dying?

Jo182 asked...

My father has metastatic bladder cancer which has spread to his pelvic area/hip bone, urethra and lymph nodes. He has been bed bound for six month and wasn't actually diagnosed until he was at stage 4. The symptoms he presented with were blood in his urine and at the time what he thought was sciatica. He was admitted to hospital in April 2008 weighing fourteen stones. My father is a non smoker and has always kept extremely fit, He is 70 and climbed one the largest mountains in the UK only in December 2007. I can't accept how he became very ill so quickly. He is very weak and now weighs a mere 8 stone. At present he has a chronic chest infection which doesn't seem to clearing with the aid of antibiotics. My Mother has to coax him to eat and they both refuse to talk about his prognosis. I get the feeling my Father wont be around much longer and I need a honest opinion from you so I can start to try and let go and say the things I want to say to my Father before it is to late.

Expert Answer

Senior Editor Melanie Haiken, who is responsible for's coverage of cancer, general health, and family finance, discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions.

Dear Jo182,

I wish doctors were better at talking about these issues, so that those of us caring for parents and loved ones with cancer had the information we need to make difficult decisions. It sounds like you're going to need to have a conversation with your parents, and ask them to relate in as much detail as possible what your father's doctor has said.

Even better would be to speak with your father's doctor yourself, and you might consider asking your father if he'd mind if you did that. You can explain that you'd like more information about his condition and treatment so you can help out better, and rather than exhaust him with trying to relay and explain it all, maybe you could speak to the doctor directly. (Usually you will need your father's permission to do this, however.)

A diagnosis of Stage IV cancer by definition means the cancer has spread to other areas of the body. You don't say whether your father is having chemotherapy, radiation or other treatments, but  if he's not, then that would indicate that the doctor has concluded the cancer is not treatable. If he is having treatment, you can ask your parents or the doctor what the goal of treatment is: is it to push back the cancer, or is it just to control symptoms so your father is more comfortable?

Doctors often seem to have a very difficult time giving patients and their families an honest prognosis and discussing end of life issues. The best way to get past this is to tell the doctor that you can handle it, and don't want your information "sugar coated."

Sometimes parents also have a hard time being open with their children in sharing this kind of information, out of fear of worrying you, or because it's too emotional and hard to talk about. But if you explain to your parents that it would actually be easier for you if you could understand what's happening, you should be able to get a better picture of what to expect in the coming months.