Hi Everyone,

Last summer I wrote about my 81 year old mom and her battle against cancer in her jaw for the last two years. She had chemotherapy, then 7 weeks of radiation, then a fibular flap surgery last July. In November she developed an infection and last month the metal had to be removed from her jaw. Biopsies tested positive for more cancer in her jawbone and in the floor of her mouth. A chest xray also showed spots on her lung which we have just been told is metastatic disease.

Throughout all of this, she has been treated at the University of Southern California Medical Center in Los Angeles. Unfortunately the doctors do not really work together, they just pass my mom on to the next guy. The surgeon's last words were "I've done all I can for her" and referred her to yet another medical oncologist. Mom does not want anymore surgery, radiation or chemotherapy.

I guess my question is this: who oversees the "comfort care" when a patient no longer wants curative care? Is it appropriate for her internist to provide that, or is it usually an oncologist?

I'm not sure where to post this, so Brian you can move it to wherever is appropriate. Thanks.

I think that you should talk with the social worker at the hospital. They have all the information that you will need regarding palliative care and hospice. As to the doctor, his only issue in the future will be pain management if further treatments are not to be undertaken. Either doctor that you have mentioned are capable of this, so I would choose the one that your mother and the family feel the most comfortable with as a person. The one that takes the time to listen, and that you feel genuinely empathizes with the process that you are about to go through. I think that I speak for all of us here in expressing my sorrow at the outcome that is the final result of all that she has been through and endured during treatment. I wish her and all those that care about her, strength in the upcoming days, and a chance to enjoy each other

Brian, thank you for your reply. I am going with Mom tomorrow to see her internist and we are going to ask him to oversee her pain management and refer us to a social worker. I can't begin to express how grateful I have been for this forum. At all hours of the day and night, in confusion, anger, sorrow and triumph I have looked to people on this web site for support and encouragement. More information is available to me here than from any doctor who has treated my mom - and there have been plenty! I'll keep everyone "posted" on her journey.

Thank you for the kind words, the people who populate this forum are indeed, an extraordinary group of caring and giving individuals. I wish that there were something more that we could do, it feels so helpless to be without an alternative. Know that you and your mother are in the thoughts of many here.

Hi Jane,
I am terribly sorry to hear about your mother. My father died of Lymphoma and I had hospice care for him at home. They took care of pain management, sent a nurse out weekly, education of caregivers, provided appliances to make life a little easier like wheelchairs and commodes and bathing and respite care. After my dad passed they provided grief counseling. I was very grateful to have the support they gave me. I hope this helps...

God bless you,

Gary Stage III, SCC, right tonsil

Thanks, Gary. We are meeting with Hospice today and my mom has chosen to stay at home. We've been very fortunate to have two extraordinarily kind and gifted caregivers with her, and we're confident that all the good things we've heard about Hospice are true.

Mom actually seems peaceful now. I think it's somewhat of a relief not to have to make any more treatment decisions and we are all doing everything we can to make this time meaningful for her.