What to do when patient says no to treatment?

I care for my Father who was diagnosed with prostate cancer almost three years ago.  Gleson 9. Spread to lymph nodes.  His treatment has been working well up until recently and was suggested last week by the Consultant that chemotherapy would be next.

I was quite surprised by my Dad's reaction.  He immediately said "No!".  As a carer I said nothing at the time but was quite confused how to to react to this situation.  I was surprised by his reaction.

Do I try and convince him to follow the advice of consultant and take chemotherapy? Or just let him make his own choice?

 

A confused and weary carer.

 

  • Hi there ... it sounds like you need a heart to heart and LISTEN to your dad ... l dont know his age but guess he's at least in his 60s ... I have breast cancer ... and although I had mastectomy I said no to radio even though I was grade 3, because of skin that doesn't heal well  ...

    I told my lovely surgeon ....it is my journey and ill take in all info .. but it will be my decision ...  he was amazingly supportive, and it gave me some control back ... I'm nearly a year post op , and for me, l made the right decision ... I was so lucky, my son and close family really listened to what I wanted ... and everyone supported me every step of the way ... 

    If I get secondary at any point, I will not go down chemo route ... my family know this ... l want quality over quantity ... this is just my journey.... everyone should have all relevant info, but at the end of the day, have their wishes respected   ... I love life, like your dad probably does ... but I made peace with life .. and it's the same if someone wants treatment even when others say no more ... give us the the last say ... 

    If you can hold your dad's hand, walk by his side ... respect his wishes ... you will make it one packed with love ... you still have time to make memories ... just one day at a time ... I make sure, I have a smile every day ... because this cancer wants us to crumble and stay down ... I will use my last minute, sticking two fingers up to it ... I won't let it change me .. I will see magic in every day ... so take every day your given with your dad, and grab it with both hands, even though it will be one of the hardest things you ever do in life  ... leave nothing unsaid ... and then you'll walk together ... take care Chrissie

  • Hello there spxppg; welcome to the forum.  Sorry to learn about your dad.  However the decision is of course his to make.  You don't say how old your dad is but even if he is not elderly he may feel he has had enough and just cannot face any more treatment.  Unless a patient is felt to be unable to make a rational decision then that patient has the final say.  This is heartbreaking for you but we cannot really judge the feelings of others.  You can of course ask him about the reasons for his decision and whether he would be willing to have another discussion with his consultant but it sounds as though he had already decided that enough is enough.  I hope that others who have been in your situation will drop in and talk to you about their experiences.  Annie

  • Hello spxppg, I was in a broadly similar position when my dad chose to end dialysis. He was 83, had had kidney failure for 3 years, and basically was tired of everything. My sister and I hardly ever agree on anything, but we both felt it was his choice to make, and supported him. He passed away knowing his wishes were respected. 

    I think you were wise not to say anything during the consultation. Perhaps ask your dad his reasons in a non confrontational way, saying you'd like to understand. 

    Personally, I don't believe in extending life no matter what. Sometimes people feel empowered by making their own choices, like Chrissie. When you're under medical care, it can feel like you're on a conveyor belt, expected to take a certain direction. But it doesn't suit everyone.

    Take care.

    Regards, gamechanger

  • Hi spxppg.

    I am not a doctor, but I am a prostate cancer survivor.

    There are a number of treatment options available for prostate cancer that no longer responds to hormone therapy.  Some of these are true chemotherapy drugs, and some aren't, but might perhaps be mistakenly called or mistaken for chemotherapy. 

    From your message, it's not clear whether all these various options were fully discussed with your father, or whether he simply closed the conversation down.  You can find a webpage outlining these options on the Prostate Cancer UK website: they discuss Chemotherapy here and also new forms of treatment here. There is also a forum similar to one but specialised for prostate cancer patients and carers; join here.  Using this information, you can at least educate yourself in what might or might not be possible. 

    I was diagnosed eight years ago and fortunately mine was treatable by surgery. In the last 8 years I have seen much progress made in the treatment of advanced prostate cancer, and a game changing treatment might come at any time.  

  • Hi

    A chat with your Dad may help make things clearer to you.  My own Dad was diagnosed with Prostate Cancer at the age of 80 and was quite insistant (having listened politely to the options then available to him) that he did not want any treatment and would let 'nature take it's course'.  Mum and I were fully supportive of his decision and he lived another 5 years (when secondary cancer and heart problems became the main problem) and on the whole enjoyed those extra years and we had time to make further memories.  He also had no mental issues so was in the right state of mind to choose how he wished to spend his time.  I am now faced with my mother (92) also refusing treatment but as she is bi polar as well as physical health issues I have full Power of Attorney. In the circumstances I have had no hesitation in backing her request (having also listened to her medical/carer teams).

    I hope you and your Dad can have a frank and open chat which will take you both forward.  Jules