Looking for advice / your thoughts

My father is 85 years old and has dementia. He was diagnosed with stage 4 kidney cancer about a month ago -- large tumor outside the right kidney, some lymph node involvement and a speck on his lung -- although he has no symtoms yet. He does has chronic PHN, which is a long-term result of shingles and can be very painful at times.

Surgery has been ruled out but treatment with Nexavar has been suggested. I have read many postings about the potential side effects of Nexavar and am looking for an honest opinion from the experts -- you!Overall, his quality of life is relatively good and the thought that treatment might decrease his comfort level makes the decision more difficult.

Your thoughts?

My side effects were a stinging head(needles and pins)for 6 weeks,ice packs help this.Really red skin rask like sunburn,sore feet,nausea,diareah.Nexavar hates greasy foods and will keep you in the bathroom.Is dad going to the bathroom on his own?Or in diapers?You need to buy baby wipes for wiping instead of toliet paper(he will get sore, paper will make this worse)preperation h for burning and itching.You can apply this after every trip to the bathroom.Rice,soup,veggies,lean meats work best with this and fruit.Is your dad a diabetic?Be careful and watch his feet if he is and while on nexavar 'cause so blisters might form from putting pressure on his feet.Have a wheelchair?Might want to get dad one so he isnt walking on sore feet when he feels like going out.Might ask the doctor for a pain killer for the fatigue associated with nexavar(it gives me the leg pains and tiredness i take morphine for it.He may be cold one day,hot the next.I put a window air conditioner in my bed room and a warming blanket too,that way if i'm freezing off with the air and on with the blankets.He will get tired and sleep a little more.Give him a t.v in his room so he can watch it and not have to get up.Oh yeah buy preperation h clothes too and place them in the area.They will be with the preperation cooling gel.Keep an eye on his blood presure,buy a blood pressure kit so you can test it once a week.Nexavar can make your pressure go up,so watch this.If he complains of a headache take his pressure.go online and print out a blood pressure chart and keep record of your readings.GOOD LUCK DAD,GET WELL SOON!

Is your father competent to understand the issues and make health care decisions for himself?  If not, did he previously make his wishes know to you?  It is a very personal decision to treat vs not treat.  The most common form of kidney cancer is resistant to conventional radiation and conventional chemotherapy, but responds to the newer "targeted" drugs, at least for a time. 

The fact that he is not a candidate for surgery will tend to shorten the time he has left.  Nexavar is relatively new, and the data accumulated so far indicates that Nexavar will likely extend his life in terms of months, not years.  Since he is comfortable now, you might consider having him try Nexavar to see how he tolerates it.  The severity of the side effects may help you to decide whether to continue the Nexavar; some patients tolerate it well, but some do not.  Also, these new drugs can be quite expensive, if that is a consideration. 

You sound like you are a thoughtful person.  I am sure that you will do what is best for your father.