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Major back surgery when you have metastatic lung cancer


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My step dad is 72 and is in his 6th year of non small cell lung cancer. Its stage 3c and is inoperable. The tumor has eaten through the lining of his lungs and into his top two ribs. He is on morphine 60mg four times a day and takes 4 500mlg of tylenol with each dose of morphine. He has many underlying conditions including severe lymphedema, diabetes, neuropathy, and high blood pressure. He has also been having hallucinations lately accompanied by confusion. He has very bad neck and spine issues from sitting and being sedintary ao long. His one arm is completely deadened from the tumor destroying the nerves. He wants to have major spine surgery to help him lift his head up and give him back the mobility in his neck etc. Will a surgeon even operate on him with all of these conditions? Will the surgery leave him in worse shape?  

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Hi, Anna, and welcome.

Sorry to hear about your dad--he sure has a lot going on there. 

I'd be very surprised if a doctor would agree to do that kind of surgery, under the circumstances. Not just because he has cancer, but all the other conditions. He might well not make it through surgery.

Have you consulted a palliative care doctor? It isn't the same as hospice--it's just a specialty that focuses on improving quality of life, no matter where you are in terms of the cancer and treatment. They might have some suggestions for relieving his discomfort. 

I hope he gets some relief.

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Thank you for your kind input. He has so much going on with him and we are very worried thinking of the recovery of that invasive of a surgery while he is in so much pain currently from the cancer itself. We feel he thinks the surgery will make him better all the way around. His cancer dr is treating him in a palliative care manner. I just cant see a surgeon meeting with him and approving this type of a surgery and if he would in face be able to survive it.  We are going to consult hospice as well to see if they can help. Thanks again

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Anna, your stepdad can certainly consult with a spine surgeon. Generally a patient has to go through some pre-surgery tests, and based on his health, the surgeon will decide if surgery would be advisable. I think you'd want his oncologist to also weigh in. 

If you do engage hospice, please know that your stepdad's care would be transferred to them, meaning that he would not be treated by his current doctors. He would just be made comfortable. On the other hand, palliative care works with his current doctors to alleviate pain. 

Having been through a surgical experience (for a pacemaker) with someone with dementia years ago--and I'm not saying your stepdad has it--the hallucinations and confusion are a big concern. My husband and I had to take turns spending overnights with his mother because the hospital staff did not know how to deal with her. 

The recovery from spine surgery usually includes physical therapy. Would he be able to do it? 

Lots to consider. I hope you get answers soon. Take care. 

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Anna,

Welcome here. I agree with Lexie and Judy. Because of a multitude of complicating conditions, your dad is not a good surgical candidate. I also think it is prudent to engage a palliative care physician and perhaps to have a consultation with hospice.

Stay the course.

Tom

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Anna,

I throw my hat in with my fellow survivors; your dad's conditions likely preclude any chance of surgery, but palliative care may be what is needed to improve his quality of life.  This is a tough situation, but you'll make the right decision.

Lou

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Thank you everyone for your thoughts. I agree We don’t think surgery is even an option for him. When he is lucid He’s adamant from hearing it from his dr’s and a surgeon because he keeps thinking he’ll have the surgery and he’ll be back to normal. He is experiencing some denial which makes it really hard but we can’t imagine being in his shoes. We don’t want him to suffer more than he is. My mom is going to contact hospice to discuss further palliative care options. 

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Is there a doctor he particularly likes/trusts who could maybe break it to him that surgery would not be a good, or even realistic, option for him? It might be helpful if other options could be laid out for him at the same time. As in, "Unfortunately, it would be too dangerous for you to perform surgery. But here's what we think would provide a serious chance at making you feel better than you do right now." I don't know if that might get through to him, but might be worth a shot.

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Yes he does have one particular Dr he really likes and trusts. I think if he heard it from him it may make a big difference and then discuss alternative options to at least improve his quality of life. Its definitely worth a shot. Thanks again

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Wishing your Dad the very best!  I had hip replacement surgery in September after months of pain and having to use a cane to get around.  I put it off for a long time because I was scared (not a fan of surgery) and then of course had to wait for Covid to decline so I could have it.   Best thing ever and now I'm back to walked well and not living in horrific daily pain!    I truly hope your Dad can have his surgery and a better quality of life!   

 

   Lisa

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So sorry to hear about your dad. I do know that surgery, radiation, chemo etc are used as part of palliative care..in essence the treatment is done solely to relieve symptoms (usually pain)

I am confused a bit however. Do his doctors recommend against the surgery? You didnt say that. If it was me and a surgeon was willing and the expectation was reduced pain....I would do it, but that's just me.

Please keep us posted

Peace

Tom

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Thank you everyone for your kind words. Due to where his lung cancer is located and that it is eating into his top two ribs his Oncologist stated 3 years ago that surgery for the cancer was not an option. It wouldve left him worse off and he would’ve lost use of his right arm. This surgery that he wanted to have is for his back and neck issues. He was also dignosed with cervical/spinal stenosis. He did see the surgeons yesterday and after four hours of testing they said he would indeed not survive this surgery. They wouldnt be able to take him off the ventilator due to the condition of his lungs. They said they would send the report to his cancer dr and said it is time for Hospice and to bring him home and make him comfortable. As I said before he was experiencing some denial thinking if he had this surgery he would get his mobility back and be better but he now is accepting that even if they were able to do the back and neck surgery he would still be suffering from the pain and effects of the cancer. He is in good spirits and wants to be made comfortable and enjoy each day as he can. 

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I'm glad this worked out. He got the testing and the truth and sounds like he's moving toward acceptance. Everyone I know whose family has turned to hospice has been very pleased with the care their loved one received. I hope your stepdad has a good experience that will ease his transition and make him more comfortable.

Please keep us posted--we'd like to support you through this.

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Thank you we are as well. We couldn’t fathem how he would’ve been able to go through such a horendous recovery being in his condition. Hospice was amazing with my Grandfather so I know they will definitely help make him more comfortable. Thank you again for your support. I will keep you posted. 

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Sorry to hear that they couldn't do the surgery to reduce the pain. Keep us posted please, especially how the hospice crew treated you. I am sure they will be fantastic. Take care of yourself as well,

Peace

Tom

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I'm both glad and sad to hear this. I'm glad the surgery issue is now clearly settled but sorry to  hear that he can''t get the surgery he wants and that his time with you is limited. I also hope you'll keep us posted and  let us know how we can support you. I wish for peace and comfort for your whole family.

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  • 2 months later...

Hello, it’s been a while since I have given an update but it’s been a rollercoaster of a few months since the last update. My step Dad lost his battle with lung cancer on June 1st. He passed away peacefully in his sleep. He had declined tremendously over the past couple of weeks then the day before he passed he had gotten up in the middle of the night and usually he would wake my mom up to help him but he decided to go it alone and he fell. He went to the er and they released him right away with a cut elbow but said he was fine. The next day he became incoherent off and on and the congested breathing began. He had a day surrounded by family and friends. He said he was in no pain which was amazing because his pain had been a 9 the previous week. He peacfully fell asleep and passed away. 

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My condolences to you and your family, Anna. Be grateful your stepdad passed peacefully. Don't hesitate to use the grief services that hospice provides. I hope the memories of your stepdad are of better times. Peace and comfort to you. 

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Anna,

Sorry to hear of your dad's passing.  It is always so hard to lose a family member, especially a parent.  I was comforted to hear that he didn't suffer the high pain he was under previously and that he passed peacefully.  That is a passing we all hope for.  Thank you for updating your situation and sharing it with us.

Lou

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I echo everyone else. Been losing a few lately. Let's break that momentum right now. So grateful he passed in peace.

Peace

Tom

Edit:See @islandgirls

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