No more scans

Diane,
I have so much empaphy for those with metastisized bladder cancer. When at the hospital with my husband for his r/c I met many women there with there husbands who had many cancer situations along with having diabetes and other complicating
factors. Its a sad place the cancer world, and for those with this type the treatments sometimes are more than they can take. Only they can be the judge on that. I wish you the best in your situation and will pray for life sustaining issues to be at least minimal for quality of life..your in my prayers, Ginger

Hi Diane,

About the scans, I suppose if you fussed and hollered you might be able to change the doctor's mind, if that is what your father really wants, if it will help ease his mind. Maybe it's that the doctor wants to spare unnecessary worry.

I think your assumption that the treatments are/were palliative is correct. Palliative treatments aren't supposed to be worse than the disease. So, it makes sense to skip the chemo if your father feels worse afterwards. And I can see the logic of not doing treatments and/or scans unless you need to run after something acute-something causing pain, and treat with radiation and pain meds.

Perhaps something less toxic is being tried in a clinical trial setting, you can always ask if there are options if your father is up to the idea.

Skipping the last of 6 cycles might or might not make a big difference, it's kind of hard to say. Did he show good response to the other cycles? If he is too weak, blood counts too low or just very sick from the treatments, it might not be worth it, could leave him open to infection and most of all, wreck quality of life.

Quality of life is paramount at this point, and scans are not what defines this.

These are tough questions and very tough decisions that ultimately only your father can make. He is lucky to have a loving daughter out here looking for some answers on his behalf.

I wish you both all the best,
Wendy

Here is what they tell me. I have stage four with distant spread to the lymphnodes around the lungs and possibly in the lungs (there seems to be some controversy about whether it is in lungs or not??). I am starting my sixth cycle of cisplatin/gemzar, then gemzar, then gemzar on the 1st. At the end of the sixth cycle they will do scans to see how much I have shrunk. I was at 40% decrease after the third cycle. If I am at 60% which is what they expect, they will not proceed with treatment till it comes back. But if I am beyond 60%, they might do more chemo to try to possibly push me into a partial remission (don't know what partial means). That is what they are telling me. I would think they would do scans periodically to see where your Dad is and not wait till he is feeling poorly. But I don't know for sure...they are all different in how they do things. I am a Kaiser patient and understand that there are some clinical trials at our University Hospital in Denver that show some promise for reoccurence of bladder cancer. So, I guess we'll see! Good luck, I am praying for you and your dad.

Dad saw his consultant at the beginning of cycle 5 of his cistplat/gem chemo who said that once my dads treatment has finished there will be no more scans

Dad has one more cycle left now, and once that has finished the consultant said that he would not scan again until dad started to feel poorly/get symptoms again his example was say in 12 months you start to feel poorly again, I will scan you then. He said there was no point scannin dad regularly as the cancer could be looking quite bad on the scans, but my dad could still be feeling ok - so it would be pointless

I am assuming from his words that the care my dad is now receiving is palliative? So they will only scan/potentially provide treatment again when he feels bad? Does this sound correct

Initial diagnosis (about 4 months ago) was stage 4 bladder cancer which has spread outside the bladder locally & spread to lymph nodes. He was told they could not cure him, and his 5 year survival chance was only 5%.

Dad was very very poorly after cycle 5 and is considering not having cycle 6, do you think this would have much effect on how long before his symptoms return?

Any advice would be appreciated

di x