Caregiver's Diary: The Cancer Years

I have been sharing the story of my 87 year old father’s journey from the recent death of my mother from cancer, through his (and his children’s) grieving and on to his upcoming move to Ontario, where he will live in a bungalow owned and renovated for him by my sister.

This story will have a relatively happy ending, but there is more bad news on the other side of my family. My wife lost her mother to a stroke 5 years ago, and she has depended on her father for support and advice since then. She is one of those daughters who is absolutely devoted to her father, and can’t imagine life without him.

In October, at Thanksgiving brunch, it was clear my father-in-law was having trouble eating. An examination and a CAT scan several weeks later revealed the unwelcome but not completely unexpected news that he had esophageal cancer, which was interfering with his ability to eat. The cancer was not advanced, but had laid claim to his lower esophagus at the stomach.

There were a number of treatments available. First of all, a stent would be placed in the esophagus to expand it, permitting solid foods to be eaten. Radiation might help to shrink the tumour. Surgery was possible, in a healthy subject, to resection the esophagus and pull the stomach up to meet it.

We had my in-laws to dinner on Christmas day. A big turkey, squash, mashed potatoes, gravy – all the things my father-in-law loves. He couldn’t eat anything except a few spoonfuls of ice cream. He had lost 30 pounds. That night, sitting around the fire, he said “If the stent allows me to eat and I can get my strength back, I think I’d opt for the surgery. But I’m not up to it in my present condition. If they can’t improve my eating, I think I might just go to bed, like my Grandfather did, and slip away.”

My wife burst into tears. She had faced her mother’s death with stoic reserve, but the thought of losing her father undid her completely.

I understood his dilemma. He’s 88 and, while in general good health, the cancer has weakened him. The surgery is major for a patient of any age, and especially so for an older person. Recovery would be long, slow and tedious, if it ever occurred. I personally don’t believe in taking extraordinary measures to prolong life, when it is obvious that the end is near. I understood his desire to just go to sleep, and drift away, rather than fight an exhausting battle. My wife has no such comforts available. All she can think about is losing her Dad, and she’ll do anything to keep him for a few more years, months, weeks.

So… the stent has been inserted, and he’s now eating more solid food. It has become a race between his ability to gain weight and the cancer’s spread. I suspect he will forgo the operation, and will concentrate on enjoying the time left to him. He was a navigator in Bomber Command during the war, flying missions over Germany. He’s often said that surviving the war was the hard part; everything else was a piece of cake. He’s one of those veterans who was so glad to survive and get home that nothing the world threw at him afterwards could darken his sunny disposition.

This is the age of cancer. I have lost, in the past year, my mother and my sailing partner. Now I learn my father-in-law has it, and so does the father of one of my oldest friends. As my friends and I live through our 50s, we are losing our parents, and none of us seem to be prepared for it. I hope this series of essays sheds some light on the pain and process of losing a generation, for the generation which follows.