Dad's been diagnosed with Bowel Cancer

[Dinoswearunderpants]

My Dad, aged nearly 71, has been diagnosed with bowel cancer.

He has surgery booked for 08/06/2023. He needs to have a hernia repaired then the cancer part removed and then areas stitched up.

He has a lunge disease called COPD. I'm petrified about the surgery. They've already said he'll likely be in ICU on a ventilator for a while afterwards.

I wondered if anyone has any experience of this type of surgery please?

To add more complications, we're due to fly out on holiday on 10/06/23. I said I was going to cancel but my Dad has said no way.

He has this superstition that because he's been in hospital before when we've been on holiday, that I need to go so he will come out of hospital.

There's no way we'll enjoy the trip if we go but I want him thinking we're going away still so when he goes into surgery, he has that mindset that he must wake up.

I'm such an emotional wreck.

I'd wait and see what the anaesthetists says before worrying about being ventilated - it's pretty unusual to plan to ventilate someone post-op. COPD may contribute to post-op respiratory issues, and it's possible that HDU/ICU is the best place to be but that doesn't automatically mean staying ventilated.

I am sorry to read your posts and hope your Dad's surgery goes well. My DH was diagnosed with a 6cm tumour and had part of his colon removed 9 years ago. It was initially staged at T3 but 'downgraded' to T2b after the operation. He had chemo too for reassurance with follow up for 5 years. It's hard to believe (and he will always be a cancer survivor, of course) but these days it is all very much in the past. His recovery was straightforward after surgery and he was in for 2 days in total, I think.

Thank you so much. I'm not medically minded at all so the whole thing confuses me so much.

My Nan had bowel cancer and a big operation that left her with a Stoma bag when she was 68 in 1992 (and I am sure that it has improved greatly since then). She died last October at 98

Hi OP my FIL had surgery for bowel cancer at 90. He didn't have any chemo, and lived a full life until a sudden illness (not cancer) age 94.

I would say while your Dad is in hospital he won't need you there in person so much, video calls etc will be fine and a great distraction. On a practical note we did need to take pyjamas home to wash in the first few days so plenty of spares (if he'd rather not wear a gown) would be useful, and a sealable bag for dirty laundry.

You will be far more help once he is home. FIL lived alone so we took easy meals over for him every day. He was horribly frustrated at not driving for a few weeks, so was more bored once he got home.

You're all so helpful and lovely, I really appreciate it.

Remembered something else- my dad actually didn't want visitors when he was in hospital- he found it stressful as was a bit out of it on morphine and coming to terms with the colostomy and really needed his privacy. My dSis and I ended up going at the same time a few times to cut down the number of visitors as he found this easier.

It was when he came out he needed the support as he had lived in his own since my DM passed away.
His brother came to stay with him and I popped in every day for about 4 weeks to help out.

I hope all goes well. My dad is in his mid 80s and had a bowel cancer op a couple of months ago. He was in good health beforehand and was able to have keyhole surgery. The surgery took 4 hours (I gather open surgery tends to be quicker). He was in hospital for just over a week. He would have been fit for discharge after 5 days but there were administrative issues that kept him in there longer. He does not have the complications that COPD might bring but has bounced back very quickly.

@Dinoswearunderpants I feel like we have been waiting forever for a plan for dad. He had a sigmoidoscopy on 5th May which showed a 'malignant looking lesion'. The CT scan was 2 days later, and a full colonoscopy a week after that. And we know nothing more yet! So it'll have been almost 4 weeks which just seems an age when it's your loved one. I'm terrified of him being offered surgery. But also terrified of him not.

@Dinoswearunderpants

My dad had his appointment today and they've pretty much said he needs surgery as no other options due to other conditions, but that they don't think his body will cope well with the trauma of the op. I think he will be in hospital for a long time.... and that's if everything actually goes ok.
He has to go for a stress test next week to see if they think he can cope. If not then it'll just be a case of leaving it and letting nature take its course which I just can't bare the thought of.

But what if he has the op and does on the table? Then I'll wish we'd just left things...

Sending you lots of love, OP. My dad also has bowel cancer, but he won't get any better. It sounds like your dad has a shot of making it through, and I'm rooting for him.

My advice is to go on the holiday. Your dad wants you to, and it could be good for you. Keep your expectations low - you probably won't want to do all kinds of exciting cultural activities, and there may be some days when you just want to lock yourself in your hotel room crying. But having someone look after you - make up the beds, replace the towels, cook - could be a lovely thing.

I am not an emotional person. However, I have spent so much time crying. There are a lot of big emotions you are experiencing and will experience, and it's important not to underestimate the impact your dad's diagnosis is having on you. Look after yourself too, OP.

As for your dad, be led by what he says he wants and not what you think is best. He doesn't have control over this horrible disease, so let him have control over how he deals with it. There may be times when he wants you there, and times when he doesn't. Roll with it.

One day at a time.

I'm so sorry my lovely. It's a truly heartbreaking time. Have they said the stage of the cancer?

Sending you virtual hugs.

I'm so sorry to hear your news. It's such a difficult time.

Hi @Dinoswearunderpants - I’m sorry to hear about your Dad. Catching the cancer in its early stages is very good news. Hopefully it won’t have metastasized (spread) to other areas. It’s very treatable and the prognosis is good of caught early enough. His biggest risk at the moment is his COPD. COPD is a progressive, life-limiting disease which has left his respiratory system (and immune system as a result) is compromised. Depending on how advanced his COPD is, this may mean that he requires extra support from the anaesthetist during and after surgery, and recovery will be slower. If his COPD os advanced enough, giving him supplemental oxygen can be quite dangerous, so I hope that he is having this surgery before the COPD has progressed to this stage. He will potentially have a higher risk of pneumonia afterwards, so he will probably require respiratory physiotherapy to assist his recovery. *Blowing balls into a plastic chamber, coughing, etc to get his lungs working at the most optimum level (for him.). I hope this helps.

@Dinoswearunderpants I don't think they have. At least dad didn't tell me.
I assume stage 1 as the impression I've been given is that if they can do the surgery then it is curative.

If they can do the surgery then I'm dreading it being right before we go away - have you made a decision on why you're doing yet?
My dad said to me, you absolutely must go away. You can't lose your money. I doubt insurance would cover us for a family member being in hospital...

It’s not unusual to be in an HDU ward immediately after a major op. It means medics can keep a close eye on the patient for at least 24 hours. I’m much younger than your dad but had similar surgery and that was the pathway for me. I found it very reassuring to be checked frequently through the day and night after the op.

Can I recommend you look at the Bowel Cancer UK website as they have all kinds of useful info and a forum where you can ask questions or share info.

You sound very experienced, I appreciate you providing me with the information.

I have a feeling his COPD is quite progressed so this isn't good. He can't walk far (25 meters?) without having to stop and catch his breathe. Some days are better than others.

I've agreed with Dad that I will go on holiday providing he is conscious and I get to see/speak to him before we fly out.

It possibly is covered. I am going along with it is covered as per my insurance policy. It says something like 'illness of close relative'. Might be worth looking.

We will likely decide if we're flying or not the day before we are due to go.

I'm sorry you've had to go through this too. I have signed up to the forum and they are all so lovely.

I've also decided to do the London to Brighton cycle to raise money for them.

Yes. Good idea.
I will check the insurance. It won't matter if they won't operate. Just need to wait and see but I'm really not very good at that. Especially when it's someone I love.

@Dinoswearunderpants It sounds like his COPD is quite advanced. I think you need to be told that his biggest risk is probably not the surgery but the anaesthetic required to remove the cancer. COPD destroys the tissue inside the lungs friable (prone to tearing). He is going to need to be 100% honest and up-front with his anaesthetist about his health issues, and make sure that they have a list of all of his meds and the medication schedule.

If his COPD os advanced enough, giving him supplemental oxygen can be quite dangerous, so I hope that he is having this surgery before the COPD has progressed to this stage

this is not terribly helpful. A proportion of patients with bad COPD depend on their hypoxic drive to breathe and may run into trouble if given too much oxygen in an uncontrolled setting, but by no means all. It's also not going to be particularly relevant perioperatively or on an HDU/ICU post-operatively because it's literally their job to manage this.

I think you need to be told that his biggest risk is probably not the surgery but the anaesthetic required to remove the cancer

this is also flipping rubbish. You cannot separate the surgery from the anaesthetic.

OP, looking after patients with severe COPD is bread-and-butter stuff for anaesthetists. By virtue of the fact that a lot of cancers are smoking related and COPD is also largely smoking related we anaesthetise an awful lot of customers with properly knackered lungs. Routine preassessment for major general surgery will flag up any massive alarm bells and give him chance to talk to them about the risks/benefits as well as make a plan for his post-op care if he does proceed. I'd probably listen more to what his actual team are telling him rather than take to much notice of the medicine you see on MN.

@Fraaahnces your answers sound generated by ChatGPT. Are you using it to sound like you have something relevant to say?

I can’t put it better than other posters here but of course go on your holiday. I just wanted to jump on in case this is useful for anyone but my FIL was diagnosed with bowel/rectal cancer two years ago. He was booked in for resection with a permanent stoma but he cancelled the surgery 48 hours before and pursued laser treatment called Papillon instead. He had to fight for it a bit and phoned the centre himself but he had it and avoided the stoma. Had some chemo too and cancer is now undetectable. I’m sure it won’t be right for everyone but even his consultants didn’t know too much about it so worth looking into perhaps.

Not meaning for your dad OP, just in case anyone comes across the thread

@Mingomang I’m a nurse. My answers are generated by experience. My mum also had COPD and lung cancer, so my experience isn’t simply clinical. Thanks for being so horrible when I was trying to help. Just so you know, every patient’s surgical and recovery experience is affected by co-morbidities. While I am pleased that your FIL avoided a stoma, we don’t know that this is even a likely outcome for OP’s father. Not all bowel cancer resections result in a stoma. Simple removal of the affected area and keeping the gastrointestinal tract intact is the desired outcome if it is possible and the area is small enough. Sometimes a temporary stoma is recommended to ensure the fastest, most successful healing outcome for the reacted area, and then it is removed once the specialist decides the patient is well enough and normal gastrointestinal movement is returned.