Hi EA -- My heart aches for you and your family. Both my folks died of cancer and I felt desperate to spare them any suffering, and also desperate to hold them here.

As you mention, no one can predict treatment's impact on an individual's quality of life. Worse, there's no certainty that treatment will succeed. Compounding the dilemma, one person may bitterly regret living with a side effect that another accepts as a reluctant gamble of quality of life for quantity. The calculus is entirely personal.

One thing that is certain is that a good outcome requires a determined patient. Being strapped to a radiation table or hooked up to a chemo IV is the easy part of the job. It takes tremendous will, though, to eat and drink when you're nauseated, have excruciating mouth sores, or everything tastes wrong. Fall short, and at best your body will take longer to heal; at worst, you won't be able to complete treatment. In your Dad's case, he'll have to take in enough water to protect his remaining kidney from dehydration and/or chemo toxins.

Beyond that, many of us have to commit to daily fluoride treatments and scrupulous dental care in order to keep our teeth, 7x/day exercises to minimize lockjaw, therapy to regain speech or swallowing skills, range-of-motion exercises and other self-care regimens, some life-long..

Complying doesn't guarantee successful treatment and minimal side effects, but failing to comply is a guarantee of less favorable results. Your Dad's level of commitment will strongly influence his outcome and should be factored into this decision.

A hospital social worker can help your family look at all the factors. I hope you all find peace, whichever direction is taken.

Lynn