04-09-2010, 01:01 AM
There are two things that are most important in making this decision... your dad's quality of life, and what he wants for himself. I understand that you want your dad with you for as long as possible but you ultimately have to do what's best for him and act accordingly, even if it's not what you want.
Perhaps the biggest debate in the medical community is "when is medicine doing more harm than good?" I've seen too many patients kept alive long past the time when they had any quality of life and against their wishes because their families couldn't bear to let them go. When it comes to using advanced medical procedures and treatments that will only extend life by a small amount of time the best interests of the patient have to be paramount. Does your dad live every day in pain? Can he enjoy his life, or is he unable to do things for himself anymore? Is he able to make his own decisions about how to spend his day and have meaningful relationships with friends and family? If he's bedridden and in pain, then treating this cancer to buy him more time will only extend his pain while prolonging what is sadly inevitable. The other thing to think about is the fact that the cancer treatments are hard on anyone, and this is exponentially more true for people past the age of 80. If he has cancer that has spread to the brain, treatment will likely only buy him months at best. The question becomes is putting him through the treatment worth it? Is it going to be better to make him comfortable now and let him enjoy the time he has left without chemo side effects? That being said, some docs offer treatment options that aren't aimed at curing the cancer but at improving quality of life for as long as possible. This usually involves a less aggressive approach aimed at reducing tumor size and lessening the effects the cancer has on his everyday life. Occasionally this also adds time to the patent's life, but not always. You and your dad can talk to his oncologist to see if this would be an option for him.
The other thing to consider even above his quality of life is what your dad wants. Does he want to go through the treatments? If you haven't before, maybe you should sit down with your dad and ask him what his wishes are in these situations. You mentioned that you decided on treatment, so I don't know what your dad's cognitive level is. If he's not able to tell you now what he wants, think about the type of person he has been all your life. Is he the type of man who would tolerate others taking care of him, and not being able to help himself? Or is he a man who would detest being in that position? Even if you decide to move ahead with treatment, you need to consider whether it's time for something like a DNR. you need to think about whether or not your dad would want to be put on a breathing machine or have CPR done if the time came. Just know that signing a DNR order is not the same as giving up on your father. It's simply a way of preventing him from being kept alive solely on machines. Unfortunately, while medicine can pull off seemingly miraculous deeds, it's not like on TV. Docs can't fix everything, and there comes a time when a person has to decide how they want the end of their life to be. If and when the time comes, you may consider talking to a hospice agency. They are well versed in end of life issues, and do everything possible to preserve a person's dignity every step of the way.
You are not wrong for deciding either way. Your dad (or you if he can't) has to make the decision that is right for him, and for his situation. Nobody on the Internet can tell you what the right answer is, because there isn't one. You obviously love your dad and want the best for him, or you wouldn't be here asking for advice. I wish you and your dad the best in this journey, and for the record I think he's lucky to have someone like you, who regards his well being so highly, as his child.
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