Do we finally give up?

Respectfully, this is such a personal question, given what you report, I would want to keep my fingers off the patient's decision making scale. That may allow you to be more easily supportive of him and others who may struggle with a no treatment decision. Should it go that way.

Hi B, 

So very sorry for what your father-in-law and family have been through.  The question you ask is clearly very personal.  It is really only your father-in-law who is in a place to decide what is best for him.  Though I know that those who love him certainly want to pursue every possible avenue for treatment.  The institutions you name certainly have some excellent melanoma specialists.  You don't mention anti-PD-1 (Nivolumab/Opdivo or Pembrolizumab/Keytruda) however, you do mention numerous trials and given the docs I know by reputation and via other patients at those locations, I am sure if those drugs have not been employed, I suspect those docs have determined that your father-in-law is not in a position to utilize them at this time.  There may well be additional trials that your father-in-law could possibly enroll in.  But…he would have to want to, and if he has already been in clinical trials AND is dealing with problems with liver function, it can be very difficult to pass the exclusion criteria written into the trials in question.

I know this must be a very difficult time for you and your family.  I guess my best advice would be to find someone (or multiple someones) that your father-in-law is most able to talk to, in order to give him the freedom to speak about what he wants in all of this and follow his lead.

I wish you and your family my best.  celeste

Hi;

I did not experience this with Melanoma but my first wife suffered from a terrible disease. It was a long hard three year process part of which included having her kidney's fail. This required her to start twice a week dialysis. The whole process became harder and harder including an inability to eat and the next step would have been a feeding tube. She and I had a long talk and she decided that she had fought enough. She started hospice and in 4 days she went home. I do believe this is a very personal choice. It is a discussion that needs to happen but it is important to ask yourself, if we continue to push further treatment, who are we doing that for? The patient or the patients family. Nothing will make this process or decision easier and I am so sad you have come to this place. Blessings to you and to your family.

Ted

Walked this road with my husband who passed from neuro-endocrine cancer.  It was heart breaking for him because he felt the doctors had "given up on him."  When it was time for the hospice decision-making talk, I flew his sister out so that there would be one person in the room who was not on "team hospice."  His desire to be home outweighed his disbelief that his journey was ending and he agreed to hospice.  I'm happy to say that while the doctors felt he only had a few days to a few weeks, he lived at home for five months in relative calm, resting his "typeA" personality for the first time 40 years.  Your father needs to know that he'll be OK at home, and that you will be OK with his decision – even if it is another trial that may fail him.  I wish for you and him; rest, good music to listen to, old stories to retell and peace at the end.