At 77, how can my grandfather manage bladder cancer?

Question

Hello, Doctor,

I am very worried about my grandfather, who is currently 77 years old. About a year ago, he was diagnosed with bladder cancer after he started passing blood in his urine. After further examination, it was found that one of his kidneys had shrunk and stopped functioning, and it was surgically removed along with the tumor.

At the moment, he is unable to walk. He has significant swelling in both legs and has lost a lot of weight. Chemotherapy has been considered contraindicated because he has a weak heart, with an ejection fraction of 46%. Please tell me what the suitable treatment is for him.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I really understand his situation, and I would recommend stopping chemotherapy at this stage. It may be more appropriate to consider targeted therapy or immunotherapy, as these options are often associated with a better side-effect profile. This is particularly important because he has started to develop cardiac complications, with an ejection fraction of 46%, which is considered reduced and raises concerns about his ability to tolerate further chemotherapy.

The most suitable treatment option for him would depend on the histopathology and molecular characteristics of his cancer. In addition to medical treatment, he needs strong supportive care, including emotional support and nutritional support. Encourage him to do the following things,

Eat fruits and nutritious foods.
Stay hydrated.
Consume plenty of fluids.

I understand that he may have a poor appetite and difficulty eating or drinking, but offering small, frequent meals throughout the day can sometimes help. At this stage, we also focus on palliative care measures to improve his quality of life.

If there are metastases causing symptoms, palliative radiation therapy may be used to relieve them. If he is experiencing pain, appropriate pain management is essential so that he can remain comfortable and maintain as much normal daily function as possible, including eating and drinking.

I hope this information helps you.

Feel free to ask further queries.

Thank you.