Hi,
I'm sorry to meet you under the circumstances. When bladder cancer/TCC has spread to the bone surgery is not done, only palliative treatments are used, such as radiation and chemo. It sounds as if your father should be getting guidance about what the goal is. I'm going to quote what I wrote for the metastatic page on the main website; of course only your father can decide what is right for him at this point, and in the future.
From
blcwebcafe.org/metatcc.asp
Benefits from treatments include control of symptoms and possible prolongation of life. The most important concerns are:
Will further treatments improve my quality of life?
Will benefits outweigh risk and discomfort?
Will further treatments add to survival?
What feels most comfortable to me?
Do I feel I can manage the side effects of each treatment option? What kind of support will I have from family or friends? Outside agencies?
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Many studies cite the addition of 2-3 months to a person's life as justification enough for aggressive chemotherapy. Ask your doctor how many patients he's treated with the same therapy and how the patients did. Palliation of symptoms alone is still a valid goal in metastatic cancer.
Because the needs of metastatic patients are highly individual and many of the treatments are still experimental, there are no standard guidelines available to either the patient or the doctor. In some cases the decision is determined by whose opinion you seek — a surgeon will recommend surgery, an oncologist chemotherapy or a radiation oncologist radiation therapy. Often, the patient and family must decide on the course of treatment. .
When faced with two different opinions about treatment, consider seeking a third opinion from a nationally recognized cancer center. Although it can be very difficult to focus in the face of metastases, it's important to take the time needed to investigate available options before coming to a decision.
New treatment modalities are being investigated in clinical trials for advanced bladder cancer; given that existing therapies are often inadequate, participation in clinical trials is often recommended for those with a stage IV bladder cancer diagnosis. See clinical trials
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Best wishes, and here's hoping the upcoming PET scan will show that treatments have helped considerably.
Wendy