Hi everybody,

I am here as a Caregiver. My Grandpa is suffering from Cheek Cancer which at the time of diagnosis also spread to Jaw bone. This was in December 1st week 2011. We consulted the Oncologist Surgeon and specialist who suggested if we are going for surgery it would be 3 months of radiotherapy and no chemotherapy suggested. But they said during the operation they might remove a part or full lower jaw. He is also a patient of Alzheimer and considering his age (71 Yrs) most of family doctors suggested not to go for operation.

Now, when I am writing this on this forum, he is severely in pain and has complete lower jaw affected with the cancer. He also has growth between the lower lip and lower teeth. and below the tongue as well. He is also having a small aperture formed in the bottom of the chin, where we have continuous secretions of the infected jaw.

At this point we are very confused within our family what needs to be done and how can we help him so that t=his suffering is lessened.

Expecting full of suggestions from this forum which would take me and my family to go further in giving him the care he requires at this stage.

Thanks,
Sai

Welcome to OCF, Sai! Im very sorry your grandfather is going thru this! The operation you are talking about is called a mandibulectomy (removal of lower jaw). I have had this surgery. For many it goes smoothly with the doctor using a piece of leg bone to replace the jaw they remove. The hospital stay will be usually be anywhere from one week to one month depending on complications and his recovery. It is a very long surgery, 10+ hours.

Your grandfather needs pain meds. It sounds to me like his cancer is a Stage IV as it is in a large area affecting several things. In my opinion he should have the fentanyl patch at least 50mgs, it will take about 24 hours to work. He may need 75 or 100 to control his pain if it is that bad. But starting at 50 will help and its always easier to move up to higher dosages. This patch needs to have the directions followed exactly with never bending, tearing or folding the patch and no hot baths or showers. It gets changed every 72 hours. He should also have something for breakthru pain. Nobody should have to be in pain. I know how much the jaw can hurt and its terrible. Talk with his doctor immediately and get them to give him something strong for the pain.

I do not know what type of medical professionals or facilities you have available in your country. I would suggest getting your grandfather to the very best comprehensive cancer center where they are the most familiar with head and neck cancers. A small treatment facility may not be experienced in treating someone who has oral cancer, it is often not one of the common ones so the choice of facilities will play a big role in his treatment plan.

Best wishes with everything!

Hi Christine,

Thanks for the warm welcome and I'm pretty much happy by the way you responded.

Could you let me know if I can go ahead and add some of my queries related with your reply right here or do I need to go to a different forum. As I'm new to OCF suggest me accordingly as I'm concerned of the rules of OCF as well !!

Post away right here.

Sai, after a few posts, you will get the hang of it and be posting like a pro. Its ok to continue asking related questions right on this same thread.

Hi there - sorry about you grandfather - it sounds to me like you decided against treatment for him, is there a hospice service available? They would help with pain medication etc... I'm not sure if that would be a common servic offered in India.. Perhaps eshwar will b along to offer one advice. Take care and saying prayers for your grandfather

Hi David, Christine and All,

Thanks once again for encouraging me to share whatever possible for making his pain lessen.

As posted in reply "Cheryld" has guessed it correct. We all within our family decided not to go with the treatment last December.

Now, as said by one of the pathologists who is a family doctor as well, his lower jaw is completely affected with cancer ( if we physically see him, it would look as if its just very loose ). As recently he is suffering more we thought we would get some suggestions from the dentists and consulted a few.

Most of them suggested not to do anything further like removal of teeth, rather they clearly suggested nothing can be done except taking care of him. Some dentists though say that the lower teeth which are 8 in number out of which 5 are dentures (artificial) can be removed. One of our closet doctor came in with suggestion to consult another dentist, where he also declined to go with doing anything further with the removal of lower teeth.

Now, there are three concerns for us:

1) He is finding difficulty in swallowing. He is able to do it, but sometimes reluctant in taking food - (food in form of thin paste). We can imagine what he is going through but unable to do anything further !!

Please advice..

2) As told earlier, he is a patient of dementia (he hardly recognizes few within our family by seeing our faces). He is hardly sleeping for few minutes. (less than two hours - and with much difficulty) He has hardly any energy left over, and continuously roams throughout the day and particularly in night. We are always asking him and trying him to make him sleep but our efforts going in vain.

Kindly advice how to make him rest for sometime (do we need to go for medication in particular, or should we be asking anything in particular about this with the doctors). Doctors have been giving pills but they doesn't seem to work.

3) In December last, the concerned Oncologists said without treatment he would have six months in hand. Do anybody over here suggests for any kind of treatment for him at this stage.

Please give your inputs.

And Christine,

Could you let me know what are these medicines for - Could you please elaborate me. I couldn't get the following in particular "hot showers".

And sorry for posting this all this long in single post, would try to make short from next time.

Sai, a hot shower is a hot bath.

I advised you to ask the doctors for prescriptions for the fentanyl patch to help him with the pain.

You have said no treatment is being done for the cancer. With that info, I would also suggest what Cheryl stated with the hospice. This is an organization which helps terminally ill patients when they are close to the end. They will manage the pain so the patient does not suffer.

Hi Sal. Afraid I haven't much by way of advice, just wanted to add my welcome to OCF and express my sympathy for the pain your whole family must be feeling. Strength to you all.

There is no treatment other than comfort if you have made the decision to let the cancer kill him. Pain meds and very very strong ones should be used to make whatever short time he has left as pain free as possible.