It is time for Hospice

I thought I would write an update on where we are with dad's treatment. Last I wrote back in May, he was having some difficulties while undergoing whole brain radiation for mets to the brain that had come back after his craniotomy in December. While we have had some good days since he came from from the hospital (he came down with pneumonia 3 weeks into a 4 week rad schedule, but he finished all 20 wbrt treatments on schedule anyway!), things have mostly just gone downhill. We hoped it was just the effects of the radiation, all the fatigue and weakness and lack of appetite, etc. Even though he had to walk with a walker, his vitals were always pretty strong, so the doctor started him back on Xeloda and Herceptin for the primary esophageal tumor in June, and weaned him off the decadron, but his body just couldn't handle it. After 2 weeks, he was barely eating, sleeping all the time, and getting weaker in his legs. I made the decision last week that he needed to get fluids, which his doctor agreed to, and we spent 3 out of the 5 days at the cancer center getting fluid infusions, plus his onc put him back on 4mg of Decadron a day. We also got the results of his scans, 7 weeks out from the wbrt. No progression of disease, but nothing shrunk either. No change. And no change in the size of the tumor in the esophagus, either. It was last Friday that his doctor decided that more chemo would just be toxic to dad at this point, and that it might be time for hospice. It took some gentle convincing, but he agreed to it today. At our appointment today, the doctor said he thinks that dad has developed leptomeningeal metastases, which means the cancer has traveled to the lining of the brain and possibly the spinal fluid, which would explain why his symptoms seem more severe than the scan would suggest, but he does not want to put dad through the ordeal of an MRI or spinal tap just to find out. Our goal now is to keep him comfortable and safe. He has outlived his original prognosis of 6-12 months now, at almost 14 months, and he has put up a good fight. I think it really is time to lay down the sword, and he thinks so, too.