My mother's husband (55yo male 30+ year smoker 2pck day, multiple co-morbidities; father was non-smoker who died of multiple myeloma at age 63 & sister died unknown causes after autopsy at age 50) was diagnosed in July with a papillary tumor of SCCB (staged 2). He had a CT and PET Scan and underwent 4 months of adj. chemo. He underwent a TURB before chemo and at the end of November; this is when it was found that the entire cancer was covered in cancer. On December 20th he underwent a cycstoprostatectomy with lymphadenectomy - we just received word that SCC was found in the lymph samples; he is also suffering from wound dehiscence. He stopped smoking in November.
My mother wants to know why the doctors (MDCancer Centers, PHX) didn't perform the cycstoprostatectomy in July. Why did her husband have to endure 4 months of chemo (a waste of time & $$$$) if the cancer was going to spread. So I started doing more research and found that the etiology for SCCB is unknown. We did find out that SCCB is agressive and metistatic and does not show up on "scans" (see above CT/PET) and that -1% of bladder cancers with a 1-9/1,000,000 dx with less than 1500 cases since 1981 - neither the urologist nor the oncologist ever provided this information. At his appointment before surgery is when they informed us of 16-17% 5year survival rate.
While I am not a physician I am nearing the end of my Master of Science in Public Health and know AP, Pathology, Epidemiology, and BioStats - so I am thinking that the original dx of stage 2 was incorrect. I also understand that there is no standardized protocol for treatment of SCCB but that it is a pulmonary cell and since SCC of the lung responds well to chemo and radiation therapies that it is believed SCCB would do the same. I did read one meta-analysis research paper that showed a median survival rate after treatment (depending on type of treatment) of 4.4 months - 7.6 months - 9.9 months.
Now with the findings of lymph involvement, I have been reading about average 10 month survival rate after treatment. Not at any time did the doctors provide him with the option of not treating it - not a very Patient & Family Centered Care aproach.
What I want to know most of all is what should we be looking for towards the "end" and how should we best prepare for it - i.e. hospice? Should we be looking for specific S&S like pain, weight loss, etc. Another question is should we be getting him on SSDI or will he be able to return to work?
I appreaciate any and all recommendations for this patient situation!