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Original poster

BIL cancer and way forward

157 replies

SweetSunshineSA · 30/10/2025 06:18

I have name changed for this as I am a long time poster but have never spoken about this part of our lives in detail as its not something we center our lives around but its there nonetheless.

There is a lot of detail to the this (as its a lifetime) and I cant possibly tell the whole story without writing a novel, so please ask questions if you feel they are relevant and excuse me if I dont cover all the information upfront. Also, we are not in the UK.

My DHs brother, my BIL has not had a very productive life as an adult. He hasnt held down a relationship or marriage for longer than two years, is generally a difficult character with strange ideas, he has been financially reckless to the point of almost living on the street and has never looked after his health. My DH wouldnt consider their relationship close but if you had to ask my BIL he would say that they are. Its a strange dynamic of a younger brother being the one who has always looked after the older brother due to his bad decisions and inability to 'grow up'. My BIL would say this out of love but my DH would say it was out of obligation. Neither of their parents are alive anymore so they are each others only immediate blood relations (besides for kids). My BIL has a daughter in her early twenties from a short marriage.

My BIL was diagnosed with a brain lesion a few years ago which was causing seizures, he was on medical leave from work (he was employed by us prior to this, but this is another story) and we discovered that he was living in a flat in town but had gambled away his entire insurance payout and sold all his belongings and was sleeping on the floor. We uplifted him and placed him in a residential home / care environment where got a roof over his head and 3 meals a day at our expense. His health deteriorated and we took him to the doctor and the lesion had turned into a brain tumour (grade 4 aggressive, Im not sure of the pathology). He underwent a resection, they removed the tumour and he had chemo and radiation. He returned to the care facility but is now in frail care as he is not coping with normal day to day life. The tumour itself has caused brain damage and his cognitive function is impaired. His motor skills are getting worse and worse. He is struggling with bowel control. My DH speaks to him once a week on the phone and I get updates from the nurses at the facility. All his care, medical etc are paid for by us at a fairly large expense but we can afford it luckily.

My DH is struggling with the idea that his DBs life is effectively in his hands and he has to make decisions about his care and well-being. Obviously, if the relationship had been close and 'normal' then I think he would feel different. We (my DH) have to now decide whether we take my BIL in for follow up brain scans. We have been told that the tumour will likely reappear in the next few years after the surgery (its been a year now), he has had one follow up scan which was clear. We dont have all the medical info as we havent always been involved in his oncology appointments and have struggled to get doctors to communicate with us when the patient is an adult himself so the messages we have received have been mixed, ie some say they would operate again if it reappeared, others have said they wouldnt.

We have noticed in the last few phone calls and conversations with his carers that his condition seems to have gone downhill again. What do we do? Do we go back to his medical team and have scans so we know what is going on inside his brain? Do we leave it and let a very aggressive cancer take its course? His quality of life is pretty rubbish and I dont see it improving. We have had to tell the care home to not let him out anymore as he is catching taxis and ubers at his free will and its not safe outside of the facility for him My BIL wouldnt be able to understand this conversation if we tried to have it with him.

I feel like Ive left out a whole lot of details which make the question sound quite callous and uncaring. What do we do?

OP posts:
BastardtheCat · 30/10/2025 06:38

I’d say that it’s important to establish who makes decisions over your BIL if he is incapable of making them for himself. In the UK, as the previous poster said, it’s called the Power of Attorney and given that you and DH are paying his bills and DH is his brother, that may very well be you two.

Is his daughter in the picture at all?

If this were me, I’d sort POA and then be led by his medical team - it sounds as if a palliative care pathway could very soon be needed if the tumour is aggressive.

Despite your BIL’s very erratic life (was he ever screened for autism?), his medical condition is very sad and you both clearly feel a duty of care over him.

HeavenInMyHeart · 30/10/2025 06:38

SweetSunshineSA · 30/10/2025 06:34

Like I said. There are a lot of details which cannot be covered in a single post.

The relationship was severely strained and almost no contact prior to diagnosis. There are many people who would have done a whole lot less than my husband has done for someone who has been a pretty awful human being in his lifetime. I have tried to leave that out of my post because it would then become about me not liking him and not about what the right thing to do is.

Would it be fair to pass the decision making onto his young adult daughter who virtually has nothing to do with him because of previous abuse?

Show quote history

It’s clear you don’t like him and have decided that to you, his life has no value.

people with disabilities can live full and happy lives, and if I was in your shoes I’d be doing everything I could to make sure that happened. But you’ve made up your mind, so I don’t know why you’ve posted here?

Original poster
SweetSunshineSA · 30/10/2025 06:34

HeavenInMyHeart · 30/10/2025 06:28

I don’t understand why you’ve decided you know what’s going on, without the scans? It’s clear you don’t like him, and mentions of his previous employment history are irrelevant. The fact of it is, your husband is responsible for him and he needs to be fully informed of all the circumstances before a decision can be made.

Like I said. There are a lot of details which cannot be covered in a single post.

The relationship was severely strained and almost no contact prior to diagnosis. There are many people who would have done a whole lot less than my husband has done for someone who has been a pretty awful human being in his lifetime. I have tried to leave that out of my post because it would then become about me not liking him and not about what the right thing to do is.

Would it be fair to pass the decision making onto his young adult daughter who virtually has nothing to do with him because of previous abuse?

OP posts:
Original poster
SweetSunshineSA · 30/10/2025 06:30

Hoodlumboodlum · 30/10/2025 06:26

I don't understand why you wouldn't get the scans. You can only make decisions with all the info surely.

Because all the information we have had so far is that the cancer will return. Even if the doctors said they would operate again I am not sure that we would think it was a good idea. Even with his limited capacity I am not sure my BIL would go through it again. There is no way a further procedure would improve his quality of life. His physical health is poor and his mental capacity is already severely impaired.

Without sounding callous... What is the point of knowing?

OP posts:
HeavenInMyHeart · 30/10/2025 06:28

I don’t understand why you’ve decided you know what’s going on, without the scans? It’s clear you don’t like him, and mentions of his previous employment history are irrelevant. The fact of it is, your husband is responsible for him and he needs to be fully informed of all the circumstances before a decision can be made.

Hoodlumboodlum · 30/10/2025 06:26

I don't understand why you wouldn't get the scans. You can only make decisions with all the info surely.

Mayflower282 · 30/10/2025 06:23

It sounds like you are in a really difficult spot, having to think about decisions without all the information. I think you need to liaise with his medical team, find out more info about prognosis and treatment options, get power of attorney sorted out, and have open discussions about what his future looks like, pallitive care at some point etc.