My 86 year old dad is facing chemo after BCG failure to kill his bladder cancer. What's ahead for him?

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I am glad chemo helped your father and grandfather. My Dad did well on experimental chemotherapy for stage 4 metastatic prostate cancer until his last two weeks when it caused CHF and renal shutdown due to MRSA. He died after 4 days in a hospital from the bedsore caused by excessive weight gain from the renal shutdown that was inevitable. Dad lived 11 years after stage 4 diagnosis and died at 91.
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My 86 year old father in law had chemo after surgery for colon cancer and while it made his hair fall out and made him severely nauseated at first, his oncologist prescribed a relatively new drug that stops the nausea. He is now cancer free and doing a lot of travel and has a new girlfriend he lives with!! My grandfather did the same thing (pancreatic cancer). Chemo does a good job!!!
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I am sorry for each and every one of you who are going through this kind of agony with your loved ones. Someone else said it best: Dying is not for sissies. Neither is caregiving. You are all in my thoughts and prayers for ongoing strength during this stressful time.
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Dear tkraft, I'm so sorry to hear that your father is going through this; it is not something any one of us want to see our loved ones go through it. I can tell you from my experience from my beloved mother, may she rest in peace, that her chemo sessions were actually quite good. After a session she would feel tired and perhaps once in a while she was constipated, but all in all, she had no major side effects, except of course losing her hair. The one comfort she had was that when she was getting her chemo, she was amongst people going through the same thing, so she was able to talk to them and hear their stories while there. I think she actually enjoyed being there because she didn't feel so alone. My mother had cancer of the breast and lungs. I wish you all the best and may be God be with you and your father during these difficult times.
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My mother was diagnosed with stage 4 breast cancer August of last year and by the time it was detected it had metastasized. I guess we are going through with what you call palliative care. She gets small doses of chemo every 3 weeks, she gets fatigued and has had blood clots due to the chemo but she has never lost her appetite and rarely gets nauseated. We have a wonderful doctor who keeps a close eye on her and so far it appears that we have slowed the cancer down and that is wonderful. If she ever gets to point where she is sick all the time and can not eat or function normally we will stop the treatments. She is 80 and has had a good life and that is the most important part of all this. You do not want to put someone you love through intensive chemo, it will destroy the person you know and love and leave you with a lot of very sad memories. Live every minute like it is the last and do what is needed to keep them with you for a long as possible WITHOUT destroying their quality of life. My father died a few years back from multiple health issues but the cancer and treatments he endured destroyed the man I loved and grew up knowing, it was a nightmare and it destroyed his quality of life, all for nothing because we lost him anyway. I guess what I am trying to say is weigh all the options, sometimes it is just better to let nature take it's course and enjoy what time you have with your Dad. My mom could go at anytime but in the meantime we take regular trips to the casino so she can play slots, we go for long rides to look at the mountains and to flea markets and I am taking her to the beach for a week starting Saturday. I may not have her for long and want to make every moment count and if she was getting intensive treatment we would not be able to share these things, as she would be probably be in a assisted living facility by now. No one wants to spend their last few years or months surrounded by people they do not know being poked and prodded by doctors all the time. At least I know I do not want that for my Mom. I would love to have her with me for forever but we all know that is not possible so I hold onto the knowledge that I am doing what is best for her and keeping her quality of life at an optimum level while letting her go on her own terms, not in hospital bed deteriorating into someone I would be unable to recognize.It is hard road and I wish you all the best. I think I made the right decision and look forward to whatever time I have left with her.
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Thank you for all your comments. We have my mother at home as she is fully gone with Alzheimers...so dad has been her care giver along with us. ( I am 66). now, we are facing the challenge to care for dad and his bladder cancer.....he wants mother at home, and it is hard to keep her calm..now with dad,I really don't know how we are going to do it all....
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We were fortunate that in one of my mom's previous hospital stays, when she was having uncontrollable spikes of labile blood pressure, neurological issues and what looked to me like some hallucinations and paranoia, I got a psychiatric consult--I'm a psychologist, and I know that often, psychiatrists are the only docs in a hospital who actually get the "whole patient" picture. The psychiatrist determined the the issues my mom was having were not truly psychiatric in nature and told us that what we needed was a doctor who understood the "elder body, elder mind" issue. And he was so right! Since Mom has been treated exclusively by docs who are geriatrically oriented, her meds have been stabilized, no sudden changes to deal with minor fluctuations in bp, sodium etc, and conservative treatment of infections.. Overall, so much better that the "reacting to the symptom" treatment she was getting previously. So each time she has a crisis and ends up in house, we call in the geriatric guy to advise. So much better.!
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ba8alou, I'm impressed that you all thought to call in a geriatric consult, and that he was willing to address the quality-of-life issues. I've heard and read some real horror stories about doctors not wanting to tread anywhere near such discussions, and it makes me feel sad and frustrated. People who are frightened for themselves or their loved ones often tend to move in whatever direction an "authority figure" points them, because they're not typically in the best frame of mind to think things through clearly, or because they're terrified to ask the very questions that would help to clarify the situation -- or both. Sadly, this contributes to unnecessary misery and spiraling out-of-control health care costs.

My mother had four good months following eight very miserable months of treatment for her very aggressive breast cancers ... if she'd known how things would turn out, I believe she would have made the choice to forgo treatment. Of course, we don't generally know in advance how things will turn out ... but in her case, it was clear statistically that her chances were very poor from the beginning, given the advanced stage of her cancer and the level of lymph involvement by the time of her surgery. She was determined to try, so we supported her choice. To this day, though, I wonder if she fought because she thought she'd somehow be letting us down if she didn't, even though the odds were so heavily against treatment making a long-term difference?

This is the horrible position many patients facing a terminal (or likely terminal) disease find themselves in ... thinking that if they don't do everything that's possible to "win," they're basically saying to their loved ones that they don't care enough about them to want to stay. It's so, SO important for families to talk this all through as frankly and honestly as possible ... the worst situation is when the loved ones don't want to see the cancer patient struggling with futile, misery-inducing treatments, but don't say anything because they want to be "supportive," while the cancer patient endures hell because he or she doesn't want to "let down" the family.
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My 92 year old father fought to live until his last breath. He had chemo up until 4 days before he died. On that day, he was rushed to the ER with MRSA and died four days later. His stage 4 metastatic cancer did not kill him but his doctor and I were about to discontinue chemo for him because it was causing heart and kidney failure. All together, he couldn't overcome these insults to his body. I would say the last two weeks of his life on chemo were not worth it in terms of quality. But he knew he would die if he discontinued. He would have died anyway. He fought the good fight. I miss him everyday. He did not crap on like my mother-in-law. Compared to all the sick people I take care of, her depression and refusal to go to therapy for it is exhausting to all stuck taking care of her. Her husband had Alzheimer's and he wasn't a complainer. He was a gentle soul who couldn't remember where he was and would get violent if woken up while sleeping (because he fell out of bed) but for the most part I have not seen the endless bitterness my MIL seems to spew on a daily basis.
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A little back story here, mom will be 90 next month, has mild chf and is in independent living at a nice facility. Last year, she had a pulmonary effusion and they found a few abnormal cells. The oncologist wanted to do a bone marrow biopsy. We called in a geriatric consult, who agreed that any treatment they might contemplate would substantislly worsen mom's quality of life . And he advised, if you're not going to do the treatment, doing an invasive and painful test is worse than useless.
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