My dad is 76, a lung cancer survivor with one lobe removed back in 1994, diagnosed with COPD in 1989, now has late/end stage COPD (on 02 24/7), tires easily, dsypnea, hypercalcemia. He was diagnosed with oral cancer - tumor on the right mandibular posterior. The tumor was surgically removed on August 12, at Loyola University MC in Maywood (Chicago), IL. Long story short, he's now in RML speciality hospital in Hinsdale being weaned off the ventilator. He's progressing okay - off the vent for several days now, still has the trach tube in, and an NG feeding tube, which will be changed to a stomach tube in the next few days. He really is having trouble breathing - Goes to PT, walks 12-20 feet "with guided assistance" and has to rest for 1 to 1-1/2 hours, which is actually interfering with his speech therapy.

Okay - took me a while to get to the point - I finally got his path report today. (I live in S.E. Georgia) The tumor was 2.6 cm with moderately differentiated squamous cell carcinoma; 2 of the 32 lymph nodes removed contain metastatic carcinoma with extranodal extension - salivary gland tissue with no specific pathologic changes; and margin base of tongue, posterior, shows focal high-grade dysplasia with no evidence of invasive carcinoma. The stage shows T2, N2B ... My mother, who is, at this point, incapable of recalling about 90% of what she is told and what she has said, said the pulmonologist told her that the surgeon is talking about radiation and/or chemotherapy.

From what I have read, my dad's prognosis is not good, based on his age, his general health, and the fact that the lymph nodes show extranodal extension. My mother said when my father had the lung cancer surgery 10 years ago his doctor said he was not a candidate for radiation or chemo because of the state of his lungs. Even if he IS ... in all honesty, is it worth it for him to go through that? Will it give him a chance at buying enough time to make it worth while? More importantly, assuming it WOULD buy him a significant period of time (a big assumption, I think), would it be doing him a favor to extend his time but reduce his quality of life even further? It's not my decision to make by any means, but I would like to be sure that my dad makes an informed decision, no matter what it may be.

I watched my husband die of cirrhosis/liver cancer, and I'm an endometrial cancer survivor and a survivor of vaginal cancer (luckily all I've needed so far is surgery), so I'm somewhat familiar with the terms of the disease and treatments available, and their effects on the body. I'm just trying to find out more so I can be helpful and supportive for my dad, my mom, my brother, and so I can prepare myself for what's ahead. Thanks.