Questions about father with pituitary tumor

I am wondering if you can help me with some information. My father is 74 years old and has a recurrent pituitary tumor. He had it surgically removed (through the skull) about 13 years ago, but the surgeon was unable to remove some of it due to the fact that some of it had grown into an area (sinus cavity, I believe) which would have caused too much bleeding. The biopsy came back as benign, by the way. So the surgeon sent him home with some medication that he was supposed to take to help keep the tumor from growing back. Unfortunately, he didn’t take the medication, and it has grown back.

He was in the hospital last week because he caught a bug that has been going around. He fell twice at home and messed the bed (diarrhea) and did not want to go to the hospital. So I stayed by his bedside for 4 days taking care of him and he made no progress. He couldn’t get up to go to the bathroom and had a fever on and off. Finally on the 4th day my mother made the decision to call an ambulance to take him to the hospital. I should add that he has a history of mental illness and a serious distrust and anger towards the medical community.

During his stay in the hospital he received antibiotics, an MRI/CAT scan to look at the tumor, EKG’s, blood/urine tests, kidney/bladder ultrasound. In additional to the tumor he also was in A-fib all week and received breathing treatments for emphysema (he is a lifelong smoker).

The problem is that he is refusing to have the tumor removed this time. He doesn’t even believe he has a tumor. The neurosurgeon who visited him in the hospital said that he could go in through the nose and remove it, but my dad won’t hear of it.
He was asking to leave the hospital all week. He thinks everyone in the hospital is just there to take his money. Finally on the 6th day in the hospital he called 911 from his hospital room and told them that he was being “illegally detained” and when they told him that the hospital can’t hold him against his will, he started unhooking everything that he was hooked up to, and refused to eat or take anymore treatments or tests of any kind. When the nurse tried to help him, he hit her (he denies hitting her).

So now he is at home. He is still very weak. He can barely see. He can barely walk because he is weak and out of breath. He has frequent urges to urinate and has trouble with bladder control. He sleeps a lot and doesn’t eat very much. His mental confusion is getting more obvious. He insists that he knows what is best for him but it is getting more and more obvious to his family that he does not understand fully what is going on.

So, now for my questions, and I am only asking for general answers here and I know you cannot specifically answer questions about him without seeing his records, but any clarification you can provide would be very much appreciated:

• Are the above-mentioned symptoms most likely related to his tumor growth?
• If the tumor is still benign, what kind of life expectancy should we expect to see with him?
• What are the signs when he is near the end of his life?
• If he does not want to receive any further medical treatment and starts to behave erratically and/or dangerously at home, what are the options for the family? We live in CA.
• If he dies at home and has previously expressed a desire to not extend his life, what does his family need to do to make sure his wishes are honored (no attempts at resuscitation)?


Is there anything else you can tell me that we should be expecting as his tumor continues to grow? I would very much appreciate any knowledge you can share with me on this topic.

Thank you so much for your time.

Not yet answered | No comments | Asked by on February 10^th, 2011, 6:56 PM | Viewed 130 times