Father in law diagnosed with Stage 4 cancer - DH response

[AnnieG1986]

My FIL (72y) has recently been diagnosed with Stage 4 bowel cancer. He is awaiting a biopsy and further scan to determine which treatment options (if any) are recommended but at this stage things aren't looking great.

I'm a little taken aback by DH (39y) reaction and would appreciate advice from anyone who has been in a similar situation. He's carrying on with life like nothing has changed - doesn't want to visit his parents (2h journey), hasn't reached out to his mum or his brother since diagnosis, hasn't visited websites offering information like CRUK etc. I have been wondering whether he is scared to confront the situation and burying his feelings but I know him and his reactions very well and he genuinely doesn't seem to be concerned. I am trying to tread very carefully and gently and not overstep the mark when suggesting we think about how we might offer practical help if FIL needs to attend chemo sessions (MIL doesn't drive and they are not near the hospital) but he dismisses it as 'fussing'. I am the one checking in gently on MIL and brother in law. DH relationship with parents in normal times is fine, not extremely close but equally perfectly OK.

To be fair to him, they don't really know a lot yet.

Stage four is obviously not good but the extent of not good and the options available are not yet known.

I think I'd probably reach out to him but I don't know if the visit etc would be better in a couple of weeks once more is known and your FIL has had time to process it himself.

Something that says 'i care' might be nice but if your FIL is a fairly closed person then chatting about lots of unknowns is maybe not right for either of them.

Don’t assume everyone reacts the same as you in a crisis. Some people are a lot more stoic about such things. It really annoys me when people get upset on my behalf. Just leave him to deal with it in his own way.

If they're not massively close and you live two hours away, there's not a lot he feels he can offer, perhaps. A lot of relationships are transactional and polite rather than deep, iykwim. I would try not to push him in what to do or feel.

He's pretending it's not happening
I'd get serious with him, as I just did with my ex.
His father is dying. I've said to him, pretending this isn't happening steals time and opportunity from you both, and I suggest you look at this situation, if not for your father, mother....anyone else, do it for you.
Figure out what you would consider loving, supportive and respectful to do, and let that guide your actions.
Your dad may not be here to hold it against you forever, but you don't want to act in a way that you'll struggle to live with for the rest of your life.
I'll support you to do that if you need but doing nothing is one of the worst things you can do here.

Agreed - for now. I imagine in a while he will want to visit and offer support to his mother, right now it is still.a bit of a shock.

Stage 4 requires TLC and palliative care, I doubt any procedure will be carried out unless entirely necessary to make him more comfortable. My lovely cousin had the same and was very well looked after, she did not suffer. I wish the same for the op's father-in-law.

@AnnieG1986 I am sorry you are all facing this.

Forgive me for stating the obvious, there are 5 stages of grief -* *denial, anger, bargaining, depression and acceptance.

As someone who has been through it, for me the stages did not follow in sequence and I went through them multiple times. We all process it differently. There is a long way to go and your DH will process it in his way.

My advice to you is contact MacMillan, they can give you information that may help you practically as well as emotionally.

Prognosis for this isn’t good. Maybe your husband is shocked and not sure how to process.

When I receive bad news I am a bit like your DH.

A trait in my family is to be stoic and deal with bad news apart from others.

Is your DH introverted?

Give him time, when he's figured it out, he might show more compassion.

Leave him alone to process. Everyone reacts differently. He might think that there's no point in reacting until he has a proper prognosis.

I think you need to leave him to his own devices for a little while. News of this kind takes a while to process and he probably doesn’t want to go Googling for information - very wise because not all information out there is relevant to the individual situation. Maybe leave him for a while and then suggest he contact MacMillan for support and more information so he’s prepared for whatever information comes next.

Leave him be and don't bring your past resentment over his reaction to crises into this. It's his father and his path to go through.

Stage 4 is not normally curable but it’s a long way from palliative care. You can live with various cancers at that stage for five years or more, depending on the type and location and there are treatments which may improve overall survival time and quality of life. Treatment options and survival rates for stage 4 cancer greatly depend on the type of cancer, how well it responds to treatment, a person's overall health, and several other factors. It’s not just a case of making someone comfortable and waiting for death.

DH was the same when his brother was diagnosed with cancer. Bit more than two hours but he didn’t go to see him once in the time he had left. He seemed to live on denial, saying his DB was “fine” when he has carers, couldn’t go upstairs in the house, cancer had spread to multiple places and was in and out of hospital. When we got news that he was likely not surviving the day he still didn’t go up and found lots of excuses of why not to go. He then felt the death came as a shock and unexpected. I was pulling my hair out. Incidentally his DF died of cancer, too, and it was the same story.

It is really difficult but I think you need to try and get used to the thought that he might not change.

Leave him be, he's probably still processing. Also, it's worth bearing in mind that there's still a few things up in the air, no-one can say for definite what's the prognosis and plan. Even then, things change, all the time. It's also worth remember that while Stage 4 isn't curable, it can be treated and lived with for many years.

I say all this as someone who was diagnosed with breast cancer last July, had a double mastectomy, six months of chemo, radiation, and am waiting on further surgery to be scheduled for end of this year. To be honest, even after going though all this, I still don't think I've fully processed it all or it's even hit me that I have been through this. What I do know is that what they told me at the outset was very different to how things are now. Cancer is a tricky and very sneaky thing, so to be fair on your DH, until you know everything, I can wholly understand why he's being something of an ostrich.

However, should he carry on like this, you will need to have strong words with him. I'm still reeling from a family member never once even acknowledging my cancer and when I had to contact them regarding our shared genetics, they made it all about them. Ensure you DH isn't that person.

Sending lots of love to you all.

Palliative is a word that is very frequently misunderstood. It doesn't mean end of life care. It simply means treatment that won't end in a cure, but may prolong life.

My late DH was diagnosed with stage 4 bowel cancer. His palliative treatment included a full series of chemo, and when secondaries were found in his brain, regular radiotherapy. It bought him 18 months of good quality of life. Treatment was only withdrawn two months before he died, when he went into end of life palliative care, rather than palliative treatment.

It's quite possible he is in limbo so unfortunately until there is specific news he will maintain the status quo.

Erm not necessarily. Some patients with stage IV bowel cancer are treated with curative intent. If his secondary spread is confined to the liver or lung, they may have surgical options for him.

Even if not the case his prognosis is more than a year, assuming he us fit enough to have chemo.

Lot of bizarre comments on here. Op, he actually sounds like he’s taken a good dose of denial. If he doesn’t visit his dad, then he doesn’t have to accept the reality of losing him. It’s not uncommon.
Some people have a meltdown. Some people grieve immediately. Some people become über practical. Some people absorb every bit of information that they can about an illness. Some people go into shock, and some people go into flat out denial.
There's many more reactions that people can have, but the point I’m making, is everyone reacts differently.
I was in this situation with my mum. I did a bit of grieving, then became über practical (cooking for her, cleaning for her, keeping her company) but my sister went into flat out denial. Ignored how ill she was when going through chemo, barely saw her throughout the whole ordeal, etc etc.
She cringes so hard when looking back on it now, but it’s just how she coped at the time.

This.

OP your DH is either in shock or simply being pragmatic and waiting to hear the next step.

Many patients don't research their own cancers online, so totally reasonable for your DH not to be googling like crazy. Everyone reacts differently and there isn't a right or wrong way.

I'd advise you to leave him to it, because you may cause further problems if you don't.

My other half went through this ten years before me. When I had to deal with it, my OH insisted on telling me what I'd feel and how I should cope with it. It was intended to help - to protect and prepare me - but we're different people with very different ways of understanding the world.

So it just irritated me to be told what I must be feeling and how this would effect me. I felt that my actual feelings were being invalidated and disallowed. I had to explain that.

"Leave me alone. Stop telling me what I feel. I know you mean well, but it's just causing me more stress and unhappiness."

Really. Let him deal with it his way. It may be that he will never appear to you to be as upset as you think he should be. That doesn't mean he isn't.

I think quite a lot of men are like this. I am struggling to understand the lack of any practical help my DH offers his parents, but it's not really my business, so I merely make occasional suggestions like, err, maybe phoning them, since that seems to be about as much as he can be arsed doing. I work full time, he is a SAHD, so I can't help them. Must admit I find it a bit shit.

It sounds like he is in shock and doesn’t want to face reality. I think you should offer to help with what you are able to, but don’t try and force him into it.

Leave him be and let him deal with it in his own way. If he’s anything like me, he doesn’t like fuss (he’s as much as said so). One of the reasons I’d tell barely anyone if I became seriously ill.