[jack_44]

My 80 year old father was diagnosed with stage 4 small cell lung cancer about a month ago. It was diagnosed after he reported weeks of severe back pain. The cancer started in the lung, and had spread to the spine (two areas), clavicle, femur, and possible adrenal gland (or in the vicinity). It did not go to the brain.

Since the initial diagnosis, he has had two weeks or radiation targeting the spine (which has helped). Right now he is tired, weak, dehydrated, and basically bed-ridden. He doesn't eat, and when he does was having trouble keeping it down. He was hospitalized late last week to get him fluids and better care. He has not dealt with the news (from the beginning), and I feel that depression as well as lack of nutrition are mostly responsible for his current state. He is on anti-depressants which take a while to become effective, and I'm hoping they kick in soon.

I have some basic questions I was hoping some of you could answer...
1- He was scheduled to begin chemo this week, but it looks it will be postponed until he is feeling better. It's possible that the cancer (and radiation) is causing him to feel so miserable, but could it be the depression? If it is the cancer...how can they wait (for him to feel better) to start chemo if the symptoms are from the cancer?

2- if they have not treated him with chemo since the initial diagnosis (4 weeks ago)...isn't the cancer spreading (as they delay)?

3- He is stage 4 - meaning it spread from the lung - and is a fatal diagnosis, but since it has not yet spread to the brain or major organs (like liver...) is it possible that the chemo could put him in remission for a bit? Are there bad/worse stage 4 conditions? We are weighing the chemo vs. hospice, and given his age was wondering what we would gain by treatment.

Please get back if you have any comments or similar experiences.

Thank you!

[Davy9]

I would suggest that you become familiar with hospice and palliative care services in your area. As you understand regardless of the treatments instituted your fathers time is limited. These services will assist him and his family in managing this juncture of his life. They have therapies and medical management tools that will minimize his pain and the anxiety of a terminal illness. They cover all the bases including spiritual and family counseling.

You can learn more about these services from the medical social worker and your physician(s). If they do not need to be instituted immediately then wait until they are needed. They can be started and they can be withdrawn if the situation merits.

I am sorry to hear about your father. Best to you both.

[cindamae41]

I am really sorry to hear about your father. I know where you are at right now. I was told just yesterday that my father has lung cancer which has spread to his bones and liver. Since it is this early in the diagnosis, I don't know what his prognosis is but from what I've seen online, the prognosis is very bleak. I am so worried and have so many questions just like you. My father is only 69 years old with parents who lived to be almost 100 but my father was a heavy smoker for as long as I can remember. I wish you and your father the best. If you need someone to talk to, I am here for you. When I pray for my father, I will include yours in my prayers. Cindy

[jack_44]

It's been a week since I originally posted, and he's not much better. Still listless, not eating, and spending most of the day in bed. Still wondering if the cancer is taking away all his energy. It's a catch-22 because they won't start chemo until he is more mobile and eating, but he might never get there because the cancer is holding him down.

Cindy - so sorry to hear about your dad. I will be praying for him.

John

[nkalisch]

I think your father should start his treatment immediately. My mother, grandmother and aunt have all had cancer. As far as I can remember, the chemo, radiation and medications make a person feel down, sick and depressed along with other awful side effects they suffer. It makes more sense that he start treatment sooner than later unless there's any other reason such as infections or like my mother, tumors that grow and block the esophagus that needed immediate surgery. My grandmother was 91 when she was diagnosed with stage 1 NSCLC. She was diagnosed a few weeks after my mother had passed away and she was also very depressed. She qualified for radiation treatment and survived 2 sessions shortly after her second round of radiation, she suffered a heart attack while waiting for a PET Scan results. We believe that if she didn't have other medical conditions (heart problems), she might have survived the cancer regardless of her awful depression. The PET Scan reveled that the tumor had decreased in size and the doctors were surprised with her progress.

My mother was diagnosed with state 4 NSCLC which was very aggressive. She had 1 chemo treatment then it was determined that she needed surgery because they found that tumors had grown and were blocking the esophagus. I would recommend that they not have chemo before any type of surgery being that their immune system is not strong enough to fight any infection that might set in. As for my mother, she developed sepsis right after the surgery and died right after, January 25, 2008, 2 days before her birthday. I was very angry at the doctor who did not diagnose her years ago and kept saying she had allergies and adult asthma and at the surgeon. I am still angry, but I am learning how to cope with my anger.

I am sorry about your father's condition and hope he gets better. Another thing I would like to recommend is that you prepare yourself mentally in the event that he does not survive. After my mothers death I read quite a few books and found one that I wish I would have read prior to her death. It is called The Final Gift, Understanding Special Awareness, needs and communication of the dying by Maggie Callanan. Please understand that what I wish more is for your father to survive this monster, but you also have to be mentally prepared... something I was not.

Finally, please spend a lot of good quality time with your father along with family members. That is something else that will help with the healing process! Shortly after my mother's death, my sisters and I went through all our pictures and talked about the good old days... that brought a lot of comfort and joy, but there just didn't seem to be enough and I wish i had more pictures with her and her grandchildren. Make new memories, pictures, and time with him as important as focusing on his recovery and the proper treatment. It will pay off later on.

My best wishes to your father, you and your entire family!