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Questionsfordad Asked February 2017

My father (91) was diagnosed from just blood test that he has a form of bone cancer. Should we contact hospice?

Recently admitted him to a memory care facility...had a minor stroke Sept 2016. We just want him to be as comfortable as possible. Should we attempt to find out type of bone cancer and stage? Would that be invasive to find out. He has continued pain on his right knee and both legs and feet are very swollen. Ar there different types of pain relief for different types of bone cancer. I read cancer in elderly is very slow progression...is that true for bone cancer? 

pamstegma Feb 2017
My FIL had prostate cancer that spread to his bones. Oddly, all three biopsies on the prostate did not show cancer. He had a LOT of pain walking in December but when Hospice came to see him, he angrily told them to leave. A month later he was bedridden and agreed to let them provide services. He really needed the morphine they provided. The cancer worked its way up his spine and by April he was gone. I think you are in a similar situation. The oncologist may offer radiation to relieve the pain, but that is not a cure.

1angelnblue2 Feb 2017
Sorry you Dad is going through this.
My now 91 year old uncle started out with prostate cancer, it eventually traveled into his bones . It did take over 10 years for it to happen, but it did. It showed up in a nuclear scan made especially for bone cancer. We were able to find a very good oncologist who treated my uncle with medication for the past 2+ years.
Given his age and other medical problems like copd, chemo was not an option. It would have ruined the quality of life he had left. He was treated with different types of meds that have worked up until recently.

If I was in your shoes, I would not put your Dad through any painful test. If you have a good oncologist, they probably will be able to tell you more than you want to know.
The nuclear scan takes about 3 hours but it can pin point where the cancer is in his bones.

My heart is with you during this time. ❤

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BarbBrooklyn Feb 2017
A few years back, after my mom was diagnosed with Cognitive Decline ( not yet dementia), she had a chest tap that turned up a few atypical cells. An oncologist appeared at her bedside in the hospital to say they were scheduling a bone marrow biopsy.

My brother and I called the geriatrics doc at the hospital for a consult. As Jeanne said he told us and mom to think about if there was willingness to treat what might show up. Mom shook her head no. We declined the biopsy. Mom is still with us 5 years later.

Listen to what the oncologist has to say. But in your shoes, i wouldn't put dad through anything painful.

Questionsfordad Feb 2017
Thank you both for replying. We are scheduling a family consult with an oncologist without Dad. Hoping he will give us some guidance as well.

jeannegibbs Feb 2017
The general rule is "don't test if you won't treat." At 91 and with dementia would Dad opt to go through treatment for cancer? If he might, and the tests are not painful or distressing, then go for further tests. If that is absolutely out of the question, and no treatment will be accepted, then there is no point, really, in figuring out more about the cancer.

Keep in mind that dementia is a terminal condition.

Whether he has further tests or not, focus on the pain he is experiencing. Hospice may be able to help a lot -- managing pain is what they do, after all. Comfort is a great goal at this point!

I am so sorry you are facing this.

freqflyer Feb 2017
You can contact Hospice, and the Hospice Doctor will check over Dad to see if Dad is ready to be under Hospice Care.

As for checking to see what type of bone cancer Dad could have, maybe this cancer had spread from some other place in Dad's body, such as the lungs, colon, prostrate, etc. It would be best if the doctor's knew the starting place, then the POA and Dad [if he is able] could decide if the test isn't evasive to have the test done. If the test will be painful, that is a decision Dad or the POA would need to make.

Then the decision as to whether to treat the cancer or not. With modern medicine using immune therapy, it might be worth looking into.

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