When will a Doctor no longer offer Chemo?

Question

My dad was diagnosed with stage IV lung cancer 11 months ago.  He has been on 2 different chemo's, and is scheduled to take another one today.

To recap, he has tolerated chemo pretty well, no throwing up or weird side affects, other than he always feels feel and doesn't eat much.

2 weeks ago Tuesday he developed a nasty cough, I took him to a PCP and he got antibiotics, and a chest X-ray...etc, it was deemed he had a bad sinus infection...I took him back the following Tuesday because the cough was worse, and he was referred to a pulminologist, that Friday he saw his oncologists PA (he was on vacation) and she refused to start the next round of chemo because dad was coughing really bad, and she was worried about a clot in the lung and ordered an immediate CT...no clot, but lots of fluid in both lobes and now around his heart.  Saw the pulminologist on Monday he ordered home oxygen 24/7, and gave dad a bunch of nebulizer drugs to improve lung function, which he tested to be at 28%, and told dad he would see him in a month.

Now we are going to the oncologist today and I have been wondering if chemo is even a good option any more.  I mean he still has a wicked cough, he is on all this medicine and oxygen, he gets out of breath even sitting still and talking!  

When is chemo no longer offered?  At what point will a Dr say....I just don't think it is a good idea any more....because dad has made it crystal clear that IF the dr. is offering it he wants to take it.

Matt · Accepted Answer

In your dad's case it look like the PA was concerned about his immediate welfare because of the pulmonary issues and did not want to complicate the issue with chemo, which will depress his autoimmune system.  If he can be treated so that he is able to withstand the side effects from the chemo, I would expect that they will restart it.

The problem right now is not that he has cancer, but he is having trouble getting enough oxygen into his system.  Tossing chemo on top of that may weaken his body further and make things worse.

Bob B · Answer

The Doctor will suggest stopping chemotherapy if he believes that it is no longer likely to offer benefit to the patient, or if the patient is not in an appropriate medical state to tolerate it. Both of those are matters you should discuss with the doctor if want further advice on the issue.

Even if a patient is terminal, chemotherapy can still be useful to them, as it can both increase the amount of time left and reduce pain and other symptoms of the disease. As such, some patients receive until quite near the end, often with other palliative treatment as well.

So, in short, if you want to know if chemotherapy is still likely to offer any benefit, then this is something you should ask. In general, if there is any aspect of the treatment procedure you aren't comfortable with or want to know more about, be sure to ask about it (and make sure your father is comfortable doing this as well).

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When will a Doctor no longer offer Chemo?

2 Answers