what kind of doctor is this

shukudai

My father, 82, had a gastrectomy last year and was too weak for preventive chemo. Now he is stronger, has put on weight and has been feeling better since May. His recent blood test was OK, but the doctor says that anyway, "as we knew" (!), the cancer had spread and suspects that something is wrong in the patient's urine bladder - she even mentioned palliative chemo.

Well, this doctor is a new one. We didn't know that the cancer had spread - just that there was a risk that some tumour cells might not have been eliminated, but that was just a suspicion. The tests were fine three months after that.

And how could she speak about palliative chemo so bluntly? Besides, is it normal to think about that when the blood test is fine and the patient feels better?

She added that an urologist should see him in a couple of weeks. But there's a group of oncologists that will take a decision on what to do next week. If no one knows yet what's going on in the urine bladder, how can they take a decision?

I don't think that doctor is doing her work as she should.

eDivebuddy

Sorry your family is going through this. It's very possible that the spread was mentioned before but was missed. The brain just doesn’t function as well after hearing that you or a loved one has cancer. On top of that, some of the terms doctors use—what they consider plain English—aren’t always clear. For example, "locoregional" sounds like a train but actually refers to local metastasis.

It could also be that this doctor is new, in a rush, or just not explaining things well. I once fired my neurologist when he told me bluntly that my brain tumor had come back—not because of how he said it, but because I already knew he was wrong.

It also sounds like you're confusing palliative care with hospice. Palliative care is treatment aimed at controlling symptoms and improving quality of life, even when the treatment isn't expected to cure the cancer. I was diagnosed with stage 4 lung cancer and have undergone brain surgery, three types of chemotherapy, immunotherapy, biologics, and radiation—all palliative treatments. But that doesn’t mean complete remission or a functional cure can’t be achieved with palliative care. I was given a 3–6 month prognosis, yet I've been in complete remission for over four years now.

In modern cancer care, decisions are typically made by a multidisciplinary team of specialists, often called a tumor board. These teams pool their knowledge and experience to create the best treatment plan. Some cases are only reviewed once, while others—like your father’s—may be evaluated multiple times as new concerns arise.

Even though oncologists specialize in cancer, they are still medical doctors, and routine monitoring can uncover other health issues, especially in older patients. A blood or urine test might not show cancer activity, but it could indicate bladder, kidney, or other problems that still need to be checked.

Here’s an interesting fact: Early-stage lung cancer patients who undergo surgery with curative intent actually have a substantially longer life expectancy than their healthy peers. I believe this is because they see doctors more often, allowing other health issues—like what’s happening with your dad—to be caught and treated earlier.

Lastly, based on your username and your father's cancer, I’m guessing you may be at least part Japanese. I truly believe that attitude is one of the most powerful tools in fighting cancer. A ganbaru spirit made what my doctors have been calling a miracle possible for me.

You can read about my cancer journey here 

https://forums.lungevity.org/topic/53203-the-real-new-normal/

shukudai

Hello, thank you so much for your kind post. That doctor hasn't seen my father again. Maybe she was just a substitute - anyway, she explained things in a way that wasn't adequate. Months ago, the doctors had mentioned the possibility that some cells might have escaped and said that had to be controlled, just in case. Nobody had said anything for sure, or mentioned palliative care, or hospice.

But not everything has been bad. A few weeks ago, the surgeon, a nice man, talked to us and things looked better. Now they are giving him chemo and have put a device under his skin to give him the drugs.

Of course I am taking a look at the website where you talk about your cancer journey. I think you are a clever and generous person and I'm sure it will teach me many interesting things.

All the best to you!

PS: I'm learning Japanese, but I'm European 😀

eDivebuddy

Has anyone else confirmed a recurrence?

Palliative care is most often part of all cancer treatments. Here’s how different types of treatment are categorized:

Treatment with curative intent aims to completely eradicate the cancer, even when a cure is uncertain or unlikely.

Palliative cancer care focuses on controlling the cancer and managing symptoms to improve quality of life, rather than aiming for a cure.

Hospice care is centered on comfort and symptom management, without active cancer treatment. However, in some cases, limited cancer-directed therapy may still be used if it helps relieve symptoms.

Palliative Care is Not Just for End of Life

Palliative care is integrated at all stages of cancer treatment, from diagnosis onward. Whether it’s to:

Manage symptoms (pain, nausea, fatigue, breathlessness) or Improve quality of life (nutrition, sleep, mental health)

It should ALWAYS be started as soon as a cancer diagnosis is suspected.

Good luck you you guys. Maybe one day you two can go to Japan together.