Sarah,

Welcome to the neighborhood and I am sorry you are having to see your brother and now your mother subjected to this terrible disease. I am a bit concerned with the sketchy details of your brother's cancer. When you mention spreading to the lymph tissue, this is an indication that the cancer has spread to places that make it very difficult to treat. By postponing and/or refusing (chickening out of) treatment and letting the cancer infiltrate, your brother may have already chosen his destiny.

I don't know from your post where the primary cancer is and the stage and how far it has spread. Localized and in the lymph system are contradictory. Add to that the concerns of the doctors that he won't be able to eat or breathe soon and the picture I have is very grim. The pain could be caused by not taking care of himself post surgery or as you state it could be his continued smoking and drinking burning the wounds from surgery.

From what I am reading, your mother is the one I am most worried about. It sounds like your brother has already decided he is not going to fight the cancer and let it take its course. Your mother, on the other hand must feel totally helpless and majorly stressed.

Your feelings of anger, sorrow and guilt are quite normal as a family member of a cancer patient. I don't usually address something so frankly but this is a good time to form rational thoughts and do everything in your power to help your mother. At her age, do you want the entire burden placed on her? Do whatever you can to get your brother all the support you can find in the area. Check with his medical facility to find a social worker and lay out a plan to address your brother's needs. Then, do everything in your power to get your mother out of the situation if even for weekends. She may want to take care of her child without paying attention to her limitations.

My father is 74 years old and I made it a point to keep him as shielded from my disease as I can. I always portray my health as great and if it takes every once of energy, I want him to avoid worrying. There is nothing harder on a parent than seeing their child suffer.

You do not have to stop loving your brother but do realize his life is not at risk because it has already progressed past risk and is now advanced cancer. His choices of being irresponsible with his health issues and treatment options should be respected but not forced on others, i.e. your mother.

These seemingly harsh words are spoken from the heart and only intended to extend compassion to your mother. She has paid her dues in life and deserves all the comfort her children can possibly provide her in her golden years.

Ed