Conversation: The conversation between human and AI assistant.
[|Human|] Hello Doctor, My father who is 84 years old is suffering from  metastases of TCC. Currently he is asymptomatic. One Oncologist consulted wants to put him through chemotherapy. A second opinion from another Oncologist says that at this late point it is best to leave the patient untreated.  Need your advise. Also, if any treatment can be provided to avoid pain and suffering, i would like to know about the options
[|AI|]  Hi, Thanks for writing in. Sometimes it can get difficult on deciding the treatment of a patient having cancer with metastasis like your father. Chemotherapy can prolong survival in TCC with metastasis. It is important to know accurate details of the tumor in bladder and metastasis location. If the patient is asymptomatic then it is possible to further extend his survival by giving chemotherapy. Chemotherapy agents that have shown activity in metastatic bladder cancer include paclitaxel, docetaxel, ifosfamide, gallium nitrate, and gemcitabine and these are promising as they extend the survival of the patient even with metastasis. I suggest you discuss in detail with the second oncologist and then take an informed decision. Pain relief is an important part in treating cancers and this assumes a greater significance in those with metastasis. Pain relief is given using a step approach and that much of pain relief is given which can allow the patient to stay in comfort. Pain relievers are usually opioids and controlled medications.