dear swati,

i got your private mail. please consider this a response to that as well.

i personally am not in the position to give any specific advice or forecast about your father. having said that, as i understand and in concurrence with brett's post, chemo will not "cure" the cancer at this stage. in fact there are no "cures" per se for cancer, but it is possible to treat cancer in such a way that it will go in remission. this is the best case scenario which often involves surgical, medical and radiation oncology combined, and its realization depends on the type and stage of cancer as well as the individual response of a patient to treatments.

with regards to your father's situation, i would imagine that similar to my sister's case, at best, chemotherapy at this stage will slow down the growth. actually, in my sister's case, the cancer grew in spite of chemo, hence our panic. in my sister's case also, surgery was not an option. in fact, even if it was medically possible, my sister would not want to undergo surgery again. her current treatment plan is to continue with radiation + chemo, with the understanding that most likely it will only buy her time, hopefully with some comfort and quality.

in other words, we were not told at any stage that her cancer was curable. it's important that you know that when the recurrence is in previously treated areas, treatment options become very limited. in my sister's case, the reason they can give her follow-up radiation is because the first time it was not given at full dose. that became apparent only after the new radiation oncologist studied the records from the previous facility. your father's case may be different.

i agree with brett that you should discuss the possibility of radiation+chemo with your father's oncologist. it's probably wise not to take "no" for an answer unless the opinion is based on your father's specific treatment records. in my experience, doctors often talk statistically and give you a general ruling. it is left up to you to ask specific questions and demand careful and individualized assessment and answers.

if after careful assessment it becomes clear to you that the risk and side-effects of treatment may outweigh the good they may do, then your father would have to make a decision on whether or not to continue treatment and what type of treatment to choose. again, in my experience, in these situations the doctors don't tell you what to do but give you a set of options and leave it up to you to decide.

also in agreement with brett, getting second opinion is crucial at this stage before you plan further action. depending on where in california you are, you may have a comprehensive cancer centre near you. you can find a list of these at:
http://cis.nci.nih.gov/fact/1_2.htm

some centres can do consultation even if the patient cannot go there directly (i believe SFU is one of them). ask them to give you a specific list of documents they need. it makes it go faster if every piece of info they *might* need is there. (i found myself working like an archivist pulling together my sister's records from different facilities.)

finally, i'm very sorry about your father's illness and the difficult times you're experiencing now. what i found in our situation when we went through this stage was that the shock, disappointment and grief were so heavy that we became focused on a loss that had not yet happened, and thus lost sight of the fact that we still had some ways to go. positive attitude by itself does not cure cancer, but it will help you open up a space for thinking about all aspects of the situation and find what is best for you. also, i am a firm believer that real healing starts with understanding and accepting what is happening in the body and releasing it of unnecessary stresses. this is a work that takes some spiritual and emotional cleansing and a shift in orientation. because of the intrusive nature and conventions of western medical approach, we are used to thinking that we have to "fight back" the disease and thus risk subjecting ourselves to treatments that may not really be helpful when we look at the whole picture. but sometimes you need to also give yourself a break and make time for reflection, regardless of what you end up doing next. this is where we were with my sister before she decided to continue with the treatments. had it not been for this period of reflection, the positive energy would not have resurfaced. there is a qualitative difference between saying positive things and being positive in how you face life. to get to the latter stage, we need to make time to reflect on the road we've come thus far. i know how difficult it is to give yourself the permission to take this kind of time under the horrible stress that you're thrown into. but keep this in mind as something to do. the time may come once you get the second opinions and have a clearer picture.

i send you, your father and your family good thoughts for healing and peace.

be well.

gita