Refusing to see my father and he could have cancer

[TheOpalFox]

9mm mass and the doctor said it could be lung cancer and we’re really

Concerned. Referred him on.

Well the resp team have declined my dad being investigated ????? I mean what the …….

What about it grows? What about it is cancer????? So worrying that they won’t even see him 😞

Which doctor shared the findings of the mass? Was it discovered via Xray or MRI? Are there plans to do a biopsy? Sorry you're going through this.

The resp team will have given a reason for not seeing him - they can decline to see him - but they normally give a reason - it may be that the original xray had been misinterpreted and that is why they aren't seeing him.
Hard to tell without having access to his notes.

You would need to see the reasons in his clinic letters and the lung MDT notes.

If he has suspected cancer, he needs to be seen on the 2 week pathway for cancer. I don’t know what the “respiratory team” is, but as soon as I was diagnosed with cancer (and a mass in the lung is as close to a diagnosis as they get before treatment with lung cancer), I was immediately no longer seen in the department/by the consultant that I was originally referred to. My case immediately went to oncology and the surgeon.

Do they mean that the case is now too complicated for the respiratory specialist so they will not see you again because his care will now be managed by oncology and cancer specialist nurses? I think you need to follow up about the next steps. He will not just be dropped from care, but does need to be seen by a specialist team who handles cancer (and that’s probably not a respiratory therapist or whatever).

Who do I go to for this please? Can’t believe they are fobbing us off, I feel sick
I lost my mom from lung cancer last year . I will be my dads advocate xx

theyve referred him on, so you need to find out where to - call up and ask

With due respect, the person you are responding to had been diagnosed, your dad hasn't. I am not saying he won't be, but you don't know if he has been diagnosed with anything yet.

Has your dad asked you to advocate for him - is there any reason he cannot chase this up himself - as his GP cannot answer your question without his permission

When was the " mass " found - what led up to him having the xray?

You also don't know if you're being fobbed off - does you dad have access to the NHS APP - all referrals will be on there

I'd start by getting your dad on the NHS app if he isn't already.

You can see all his hospital letters on there plus his GP notes.

If you don't understand anything on there, come back and ask.

Is you dad generally in quite poor health/ v frail / has advanced dementia? Do you have POA for health?

Sometimes if the treatment options (surgery or chemo) are deemed to be too risky, or not in the person's best interests, then there is no point doing extensive / invasive tests. This should be decided by a multidisciplinary team.

Sometimes patients chose not to have investigations / treatments.

Are you sure your dad hasn’t refused further investigation and treatment?

we have been to every appointment together

Yes he’s got limited capacity and I have power of attorney

That puts a different slant on it. If he is too frail or cannot understand the instructions during a biopsy, then they won't do it. Especially if they already know he is too unwell for any cancer treatment.

How old is he?
What exactly do you want him to have, invasive tests? Gruelling treatment?

Can you give us a little bit more information so we can help you - who refused him and how? How do you know about the referral? If you’ve been to the appointments together can you not call the nurse and ask what’s going on

Is he capable of understanding that he might have cancer and can he consent to any treatment?

My mum had a small mass in her lung. They monitored it for a couple of years by x-ray then removed it and gave her chemo. She was 73 and in great health and full capacity. The operation was gruelling and the chemo even worse in fact she stopped it early as it gave her pulmonary emboli.In 2020 she had another lung nodule and had that lobe removed. Again another gruelling operation which she really struggled to recover from aged 84. Again still fully compos mentis and driving and doing everything for herself. 2 years later the cancer spread and she died.
A 9mm nodule will likely take some time to grow but it may be that your father isn't fit enough for surgery. If he already has impaired cognition then a general anaesthetic will worsen this considerably.

As doctors it is really important that we make the right decisions for our patients. I had to stop a doctor restarting futile treatment on my FIL recently. The doctor said "but he wants treatment" unfortunately he hadn't said that the treatment wouldn't work so his decision wasn't informed. He was 97! Once we had had a proper discussion treatment was withheld and he died peacefully.

It's a really tough decision and is probably the right one BUT you should have been offered an appointment to discuss this through and I think had you been able to have this discussion it would help you. I think to say "no!" Without any discussion or explanation is cruel.

I hope you get some answers.

The respiratory team would not unilaterally decide not to investigate him.
If the outcome is for no further investigations, it would have been made with different relevant specialities, weighing up the risks and benefits of the investigations and treatments, which have the potential to cause serious complications or kill him.

I would either go back to the team who informed you that he would not be investigated further or contact your father’s GP to discuss this.

Ok thankyou. Now you have said it like that it makes sense. To just be told no no further action just uoset me so much.
but now you have worded it like that. It makes sense.
thanks

I am glad it was helpful - do speak with someone from either the team or your GP, it is a lot to process and the advice I have given you is generic. I hope all goes ok as much as it can in these situations.

Thank you so much . He had a ct scan in a and e. Then they called us in saying they found a mass and will investigate, so didn’t tell us much at all!!!

I’d try and speak to your GP op, but from what you’ve said it may be that they think the treatment/investigations would cause more harm than good. Sometimes doing nothing is the right thing.
He’s lucky he has you looking out for him though.

Thank you so much means a lot. I think it was a big shock and not one specialist has explained things to me??? Ct scan in a and e, called back in for results, found a mass could be cancer, referred to specialist then declined! That was all I was told :(

Is your dad home from hospital now? He should have a discharge letter that explains the decisions made in hospital.

If that doesn't make sense of it, I'd ask for an appointment with his GP to see if they can help.