I have to agree with Gary, it appears that your dad's pain management is inadequate -- it IS a basic patient right so you need to be a firm advocate for your Dad. My husband didn't get on too well with the oral opiates (e.g., oxycodone) but the Duragesic patch worked well. However it did take (as Gary noted) a few days to adjust to this medication. He used oxycodone for break-through pain or before eating.

When and what kind of pain does your Dad have? That is, is it constant or mainly when he tries to swallow or eat? What pain medication, numbing rinses etc. has he been given? Have you met with a pain management specialist?

Is he on a gastric tube (PEG)? He has already lost more weight than the threshhold at many cancer centers for PEG insertion -- which is usually 7-10% of pre-treatment weight. If he is having a lot of pain swallowing this will greatly alleviate this problem.

However I do have to agree with several posters that it IS your Dad's life -- another basic patient right is the right to refuse any treatment. However if he does this it should be with a clear understanding of the long-term consequences. Maybe one approach would be to correct the pain medication inadequacy and focus on competent managment of other side effects and see where this leads -- ask your Dad to try this and make a decision only after every option is explored.

I went to a head and neck cancer conference last month and the pain management specialist from Hopkins was very blunt about the failure of many doctors to appropriately manage cancer pain, often for fear of legal ramifications. Needless to say he didn't have anything good to say about this as these doctors have failed their patients.

As to prognosis with only partial treatment, I only know of one person who stopped (after 24 radiation doses) and the doctors are not too hopeful about her outcome but she was having major co-mordibity issues and had to stop.

As to overall prognosis, the statistics vary but a lot depends on where the cancer is, its stage, whether the patient was a smoker or not, as well as treatment (e.g. radiation only or combined chemoradiation). You haven't provided that information on your Dad (or at least not in the above post).

Gail