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Thread: What can be done for 88-year old with diagnosed stomach cancer?

  1. #1
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    What can be done for 88-year old with diagnosed stomach cancer?

    Hi community,

    I am posting this question on behalf of my 88-year old grandfather who was recently diagnosed with stomach cancer after the doctor discovered a tumor in the stomach during an endoscopy procedure to remove gallstones.

    Currently, he is undergoing various scans to determine whether or not the cancer has spread so we're not quite sure what stage the cancer is in right now. We do know, however, that the liver and lungs look good so it hasn't spread there.

    However, we are faced with some tough questions and decisions. Because of his advanced age, if he chooses not to have any radiation/chemotherapy treatment, how long would he have to live? Assuming the cancer has not yet spread and is contained to the stomach, would removing part (or all) of the stomach increase his years or is that not guaranteed?

    Thanks for your replies and support.

  2. #2
    Senior User Dead Man Walking's Avatar
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    Dear Nobelrare: Sorry to hear about your grandfather, but at age 88 he's lived longer than 70% of the population, so he's already an uncommon case. There are a variety of problems with the questions you ask, and the 1st is that none of us are doctors, and so we can't answer any of your questions at all. The 2nd problem is that even if we were doctors, there is no way we could provide any sort of survival odds based on 7 lines of internet text, particularly without data from any standardized tests. The questions you ask can only be answered by a competent oncologist, after they have done whatever testing is necessary, which in your grandfather's case is probably quite a bit of investigation.With that being said, there is a very large additional difficulty in that as a community of cancer survivors, a lot of us have defied very long odds, so we may be the exception rather than the rule. A lot of us regard our survival percentage a standing joke, and that covers the % that the oncologist gave us, and what we have actually achieved until now.You will have to get all of your questions answered by an appropriate doctor, and that's your only source for answers for now. Due to your grandfather's age, however, there are some specific questions you and your family should be asking yourselves, and those are what are your goals for medical intervention in your grandfather's case. Is it quantity of life, or quality of life, or some combination of the two, and if it's a combination, how do you figure out the ratio between the two? These are not easy questions, but for the sake of your grandfather and the rest of your family, you need to come up with answers that your family can live with now, and for years to come.If and when you get a detailed doctor's diagnosis of your grandfather's condition with the relevant standardized test results, you can certainly post them in the appropriate cancer section of this forum, and then survivors with similar conditions may be able to give some helpful advice.

    Best regards, DMW
    05/6/16 pre-op physical for surgery show low WBC & RBC
    5/22/16 [Birthday] Results of BM biopsy: AML 25% blasts with inv t(3:3) mutation, HIGH risk
    5/30/16 Undergo 3+7 chemo, but it doesn't touch AML, infections nearly kill me. Blasts 65%
    7/04/16 Diagnosis now Refractory AML. [:tombstone:]Six cycles of azacitidine, 21 shots over 7 days w/ 1.5" needle into gut + below navel.
    11/05/16 Move to NOLA - Infusion center 4 minutes away. 15 shots for 5 days with 5/8" 25 ga. needle Huge increase in quality of life.
    12/28/16 BMB shows blasts 12%
    4/16/17 BMB shows CD34 16%, cycles dropped to 4 weeks
    7/20/17 Diagnosis changed to "indolent leukemia", aka MDS
    7/27/17 BMB shows CD34 17%
    8/15/17 Venclexta chemo in PILL form added Onc estimates survival time now 2 - 4 YEARS.
    10/26/17 BMB results show 17/20 metaphases with inv(3:3) mutation-low blood cell counts - transfusions ineffective
    12/4/17 Diagnosis: Uncontrolled refractory AML

  3. #3
    Super Moderator Top User po18guy's Avatar
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    Sorry to hear of this. What can be done at this point is that which is greatly misunderstood. Palliative care seeks to retain as much quality of life as possible, while slowing the growth of the cancer as much as possible. It is a compromise at both ends, but is not hospice - that is reserved for the perceivable end. He has lived a good, long life, although he may not be prepared to leave this life at this point. His basic health and overall attitude will go far in determining how well and how long he perseveres. It was his life, it is his life and it will remain his life.

    As with every one of us, he needs family and friends at this time. He needs to know that he is loved and that is perhaps best expressed by simple presence with him. Although the seeming end of his life is a natural thing, and prolonging it too long risks him seeing a few of his descendants go before him. I'm not certain that anyone would wish that on him. The love you have for him, and his for you, will never die - it remains in your hearts always.
    07/08 Age 56 DX 1) Peripheral T-Cell Lymphoma-Not Otherwise Specified. Stage IV-B, >50 ("innumerable") tumors, bone marrow involvement.
    08/08-12/08 Four cycles CHOEP14 + four cycles GND (Cyclofosfamide, Doxorubicin, Vincristine, Etoposide, Prednisone & Gemcitabine, Navelbine, Doxil)
    02/09 2) Relapse.
    03/09-06/13 Clinical trial of Romidepsin > long-term study. NED for 64 twenty-eight day cycles, dose tapered.
    07/13 3) Relapse, 4) Suspected Mutation.
    08/13-02/14 Romidepsin increased, stopped for lack of response. Watch & Wait.
    09/14 Relapse/Progression. Visible cervical nodes appear within 4 days of being checked clear.
    10/06/14 One cycle Belinostat. Discontinued to enter second clinical trial.
    10/25/14 Clinical trial of Alisertib/Failed - Progression.
    01/12/15 Belinostat resumed/Failed - Progression. 02/23/15
    02/24/15 Pralatrexate/Failed - Progression. 04/17/15
    04/15 Genomic profiling reveals mutation into PTCL-NOS + AngioImmunoblastic T-Cell Lymphoma. Stage IV-B a second time. Two dozen tumors + small intestine (Ileum) involvement.
    04/22/15 TREC (Bendamustine, Etoposide, Carboplatin). Full response in two cycles. PET/CT both clear. Third cycle followed.
    06/15-07/15 Transplant preparation (X-rays, spinal taps, BMB, blood test, MUGA scan, lung function, CMV screening, C-Diff testing etc. etc. etc.) Intrathecal Methotrexate during spinal tap.
    BMB reveals 5) 26% blast cells of 20q Deletion Myelodysplastic Syndrome MDS), a bone marrow cancer.
    07/11-12/15 Cyclofosfamide + Fludarabine conditioning regimen.
    07/16/15 Total Body Irradiation.
    07/17/15 Moderate intensity Haploidentical Allogeneic Stem Cell Transplant receiving my son's peripheral blood stem cells.
    07/21-22/15 Triple dose Cyclofosfamide + Mesna, followed by immunosuppressants Tacrolimus and Mycophenolate Mofetil.
    07/23-08/03/15 Marrow producing zero blood cells. Fever. Hospitalized two weeks.
    08/04/15 Engraftment occurs, and blood cells are measureable - released from hospital.
    08/13/15 Day 26 - Marrow is 100% donor cells. Platelets climbing steadily, red cells follow.
    09/21/15 Acute skin Graft versus Host Disease arrives.
    DEXA scan reveals Osteoporosis.
    09/26/-11/03/15 Prednisone to control skin GvHD.
    11/2015 Acute GvHD re-classified to Chronic Graft versus Host Disease.
    05/2016 Tacrolimus stopped. Prednisone from 30-90mg daily tried. Sirolimus begun.
    09/16/16 Three skin punch biopsies.
    11/04/16 GvHD clinical trial of Ofatumumab (Arzerra) + Prednisone + Methylprednisolone begun.
    12/16 Type II Diabetes, Hypertension - both treatment-related.
    05/17 Extracorporeal Photopheresis (ECP) begun in attempt to control chronic Graft-versus-Host-Disease (cGvHD.
    06/17 Trying various antibiotics in a search for tolerable prophylaxis.
    08/17 Bone marrow biopsy reveals the presence of 2% cells with 20q Deletion Myelodysplastic Syndrome, considered to be Minimum Residual Disease. Active surveillance is the course of choice.
    To date: 18 chemotherapeutic drugs in 9 regimens (4 of them at least twice), 5 salvage regimens, 3 clinical trials, 4 post-transplant immuno-suppressant drugs, the equivalent of 1,000 years of background radiation from scanning from 45+ CT series scans and about 24 PET scans. Two lymphoid malignancies plus a myeloid malignancy lend a certain symmetry to the journey.

    Believing in the redemptive value of suffering makes all the difference.

  4. #4
    Newbie New User
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    I have an update on my grandfather's condition. We recently did a PET scan and confirmed that the cancer does not appear to have spread beyond the stomach. There is a 5cm (2 in) tumor and the doctor recommends that we do a partial gastrectomy (stomach removal) and attach the rest to his small intestines. Grandpa also has some heart issues so we're going to check with his heart specialist to see if he can even handle surgery.

    One thing that we're concerned about is figuring out whether to go with the surgery at his age or (since it hasn't spread) go with radiochemotherapy treatments. Which is more harmful for his body at his age? Does surgery even offer any benefits considering the risk of heart issues, pneumonia, infection, etc.?

  5. #5
    Senior User Dead Man Walking's Avatar
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    Dear nobelrare: Those are some pretty complex and serious questions you have asked, and sadly not one of us has a doctor's license of any sort, much less a degree as an oncologist. Try to find at least one good oncologist, and possibly two to give you their opinions.

    Best regards, DMW
    05/6/16 pre-op physical for surgery show low WBC & RBC
    5/22/16 [Birthday] Results of BM biopsy: AML 25% blasts with inv t(3:3) mutation, HIGH risk
    5/30/16 Undergo 3+7 chemo, but it doesn't touch AML, infections nearly kill me. Blasts 65%
    7/04/16 Diagnosis now Refractory AML. [:tombstone:]Six cycles of azacitidine, 21 shots over 7 days w/ 1.5" needle into gut + below navel.
    11/05/16 Move to NOLA - Infusion center 4 minutes away. 15 shots for 5 days with 5/8" 25 ga. needle Huge increase in quality of life.
    12/28/16 BMB shows blasts 12%
    4/16/17 BMB shows CD34 16%, cycles dropped to 4 weeks
    7/20/17 Diagnosis changed to "indolent leukemia", aka MDS
    7/27/17 BMB shows CD34 17%
    8/15/17 Venclexta chemo in PILL form added Onc estimates survival time now 2 - 4 YEARS.
    10/26/17 BMB results show 17/20 metaphases with inv(3:3) mutation-low blood cell counts - transfusions ineffective
    12/4/17 Diagnosis: Uncontrolled refractory AML

 

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