Coping with Father-in-Law

Tolerable1 · New User Joined: 18 Aug 2008 Posts: 2

This is my first post.

I am 41 years old. My wife's 81 year old father has lung cancer. He has mesothelioma. It was detected last spring. It was Stage 3b at that time.

He had Chemo and Radiation. The tumors continued to grow. He then did Tarceva for 7 months. It had no effect other than to plague him with every side-effect indicated on the literature. He is now on Alitma with B12 and a few other injections.

He and I have never been close. He is a difficult person to like. He is a difficult person for my wife to love. Regardless, we both want to do right by him.

He is now on oxygen and has had two Alitma treatments. He is 130 lbs, and was on a feeding tube until it pulled out last week. The wound got infected and now he is on solid and liquid food by mouth.

Our biggest problem with him is that he has always been difficult. Frankly, I have always thought he was a little bit mentally off.

He thinks he is near cured. Even though the doctor has told him that the cancer will eventually kill him. He never took it to heart. Just like we all say that something will kill us, which is true, we don't take it to heart when we are healthy. For him, he took the comment the same way.

We have pleaded with the doctor to tell him that he has Stage 4 Terminal Cancer, and explain what that means. Instead, the doctor states that it is not a bad thing for him to be either delusional or in denial. He is not in denial. He just doesn't have the good sense to realize the gravity of the matter.

For the last couple of months, I have had to take care of all his home responsibilities. He is not mobile. Yet, he is nasty to my wife and I about things. I understand the lose of one's freedom and control are disheartening, but it doesn't help things.

Our problem is that he is constantly asking about his next treatment as he thinks everything will be better with a few more treatments.

The damn doctor won't discuss mortality with him. He believes in extending life at all costs (quality-of-life as well as financial).

Are we wrong to want the doctor to give him a prognosis?

My father-in-law continues to decline and continues to be nasty.

We feel guilt and anger -- neither being useful.

Thanks for any feedback. You won't offend me if you have a dissenting opinion. I am looking for opinions that we might not be capable of appreciating on our own.

Thanks in advance.

ChemoMan · Posted: Mon Aug 18, 2008 6:40 pm Post subject: Re: Coping with Father-in-Law

Hi Tolerable1

You pose a difficult dilemma that is by no means uncommon. First off I would like to say that your father in law is who he is, and being that way for 81 years I seriously doubt he will change. Secondly your doctor is entitled to his opinion and he has his reasons for thinking the way he does and I also doubt you can change his mind either. That being said the doctor can't make you think differently than you do , and anything you say to your father in law is your business.
What I am going to say is difficult please do not take it the wrong way. look into your heart and try and find the motives for you wanting to tell the truth. Is it to satisfy you and your wife or is it to help your father in law. Do you think telling him will help him in any way ? What possible benefit could there be to him knowing he is entering the terminal phase of his disease? your relationship with him has been difficult perhaps your motives are born out of this difficulty and this may be some way of getting back at him ? Talk to your wife about this it may even help if you both seek some professional help at this point. You didn't mention if your wife has any siblings, if she does you might want to talk to them too.
If you have done this and you come to the conclusion that telling him is the best thing to do by him then tell him. If you however come to the conclusion that telling him will primarily help you and your wife feel better, then I would not tell him.
I feel for you , it is a terrible situation you are in I hope you and your wife manage to work through it, perhaps the silver lining here is that your partnership with your wife will be stronger after this. I hope so Smile

Thinking of your and your family in this difficult time
_________________
Age 52
Diffuse Large B cell Lymphoma
Stage 2a
Finished six cycles of R chop 21 26th May 2008
Officially in remission 9th July 2008
Remission confirmed 1st October 2008
http://cancerforums.net/viewtopic.php?t=9620

pbj11 · Site Admin Joined: 12 May 2007 Posts: 1293

I'm sorry your FIL is being difficult. Cancer doesn't make saints of people, that's for sure. It seems to exaggerate a person's best qualities and sadly, sometimes a person's worst qualities.

Patients hear what they want to hear, but I feel it is incumbent on the doctor's to give it to them straight. We never suffered any illusions that my husband would survive his lung cancer at Stage IV. You can't control what your FIL chooses to accept any more than you control the rising of the sun.

As he declines, he'll come to some sort of reality about the situation. Don't put yourself in the role of the "bad guy." My guess is that he DOES know. Now -- for a sweeping generalization -- most men in his age category are tough old varmints who wouldn't let on anyway. My husband was 70 when he passed and never talked about dying. That's how a lot of people in this age group operate. Just my take.

Good luck.

PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

Beth56 · Regular Joined: 30 Mar 2008 Posts: 30 Location: California

I agree with Chemo Man and pbj11's statements.

I believe the doctors should tell their patients where they stand, but that doesn't mean they will accept it. People deal with things differently. And perhaps believing in tomorrow is the only hope he has. Is it so important that he know there is no hope? I know this is a difficult time for you, but telling him anything different is really not going to change him at this time. And often when death is near, they will not make sense anyway.

Tolerable1, I understand, but patience and understanding is very much needed right now by all family members. Sometimes the process of death is just not so nice for anyone. My thoughts are with you and your family in this difficult time. Beth

__________________________________________________

I lost my mother to inoperable pancreatic cancer in 1990 after caring for her at home for 9 months.

And, my husband was diagnosed with prostate cancer in 2006. Gleason 3+4=7 PSA 3.2. Treatment of choice was proton beam therapy at Loma Linda Hospital, California.

Tolerable1 · New User Joined: 18 Aug 2008 Posts: 2

I am writing to follow-up on my father-in-law.

I listened to the folks that commented on my topic. We never did come to terms with a solution to the moral and medical issue.

My father-in-law has been fighting his lung cancer for over a year. As stated previously, he never did understand the terminal nature of his disease.

My wife and I never did reveal to him what we knew.

He went from chemo and radiation to Tarceva to Alitma. His scans never improved, and his condition disminished with each month.

In the last month, he really has taken a turn for the worse -- house-ridden and unable to cook and properly care for himself.

We convinced him to seek a second opinion from another cancer treatment center. He really trusts his doctor and felt it was cheating to seek other advice.

The new doctor had read his chart and had an impressive knowledge of his medical history. After listening to my father-in-law, he immediately began to explain quality-of-life verses quantity-of-life issues.

Once again, my father-in-law had difficulties understanding. We finished the consultation with the doctor without his participation.

The doctor explained that the primary cancer doctor was a good doctor that was focused on fighting the disease as long as the patient had a good attitude and strong desire. He stated that if he were the primary, he would consider an immediate scan to see if further treatment was warranted. He advised us to make the primary doctor aware of the sudden downturn in health and ask for a scan even if he wanted to wait another month or two.

On our next visit to the primary doctor, he was not present -- he was giving a lecture. I discussed with doctor that covering that we had a second opinion. She stated that she had to honor the primary doctor's wishes, but that she would write in the chart that she concurred with the second opinion.

The next day, the primary agreed to a scan -- even though he had wanted to wait until a month after the sixth treatment of alitma. He stated that had another treatment he would like to change to if the scan was not positive.

The day after the scan, he called my father-in-law and asked if he could have a serious conversation with him on the phone. This was Tuesday of this week. He stated that the scan was really bad, and that he had hoped it would be better. He stated that scan was so suggestive of growth and spreading that he was now advising that all treatments cease.

He told my father-in-law that sometimes the best treatments are unable to change a bad condition. He told my father-in-law that he had the unfortunate duty to advise him that he probably has six or fewer months to live.

I visited a couple of hours later and answered the phone for him. The person on the other end was from hospice care. I could barely keep my composure.

I then sat down and talked to my father-in-law (my wife was out of town on business). We talked about the sad fact that he was dying. I told him that I had known more than I had shared with him over the last months, but that I didn't think it was my moral or ethical right to affect his spirits while he was fighting his life-or-death fight. He said he knew things were getting bad. I asked him if he had understood that he was dying earlier. He said that never really did because he was focusing on living and fighting. He said he couldn't afford to consider it.

My wife and I have always wanted the best for him, but it has been hard to stand by and see him endure treatment after treatment, hoping for something good to come of all this. He continually felt worse and worse.

So many times we wanted to intervene and make him understand the quality-of-life verses quantify-of-life decision. In the end, we never did. It just didn't seem right to take his will-to-live from him.

I feel bad that he endured so much for so little benefit. I also just feel bad for him. I am glad, however, that I didn't do anything that I might have always regretted -- crushing his hope and will.

My wife and I are still fighting mixed feelings about doctors who pressure patients to fight when the only result is just a few months of extended life. He has been miserable these last months -- sick all the time.

Ultimately, the decision was never ours' to make. It is the patient's life and decision. Still, it has really just been a sad thing to see.

I don't know if this information will help or affect anyone reading it, but I thought I would share our experience.

brainman · Posted: Fri Nov 07, 2008 1:46 am Post subject: Re: Coping with Father-in-Law

Tolerable1, I am so sorry to hear that your father-in-law is not doing well. You sound like the two of you are very close. I can tell from the way you write so beautifully that you care very much for him.

My father was living on his own too until I moved in to care for him. It was a hard 3 years with a lot of ups and downs, in and out of the hospital, and trips to the many doctors on his medical team (oncologist, bone doctors, kidney doctors, heart doctors, GP...). Like your FIL, he did not talk much about his understanding of his condition. Unlike you, I did bring it up from time to time and from those brief conversations I know he understood and that he was just trying to focus on living. We do have a choice: to live as if we are dying or to live as if we are living. I hope you FIL never gives up the fight.

This does not mean that he should not think about the quality of life vs the quantity of life issue. At some point, we all have to say: "OK, if I can't live much longer, how can I make the most out of whatever time I still have left?" It sounds like your FIL is at that point.

You and your father-in-law and your whole family are in my thoughts and prayers.
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendoglioma grade 3, same location.
My Story Part 1: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 2: http://cancerforums.net/viewtopic.php?t=8029
Blog http://jimhawkinsport.blogspot.com/

	Cancer Forums Forum Index -> Coping and Support	All times are GMT - 5 Hours
Page 1 of 1

A website for discussions about any type of cancer, including lung cancer, breast cancer, mesothelioma, prostate cancer, laryngeal cancer, leukemia, lymphoma, multiple myeloma and others