This is certainly devestating news for any patient, and also to caregivers and friends/relatives.
Right now there's much confusion, and it will take some time and effort to sort things out.
1. Last question, first: What is 'palliative care', and is it the same as hospice?
From the Terminology and Abbreviations page, halfway down the first page, here:
viewtopic.php?f=1&t=5366 :
"PALLIATIVE CARE: It is NOT the same as hospice or "Gee, we're just going to keep you comfortable." Palliative Care docs deal with all the SYMPTOMS of cancer and its treatment. So that includes chemo related nausea, neuropathy, pain, mouth sores, etc. They can be there to provide assistance to you in every stage of this disease, not just the end game! If you have access to one, take advantage of it!"
2. If BIL is going to see his onc at hospital tomorrow for some answers, then just WHO THE FAWK called him last week, sat him down at an appointment, and gave him such awful, incomplete, and stupid information and advice???
3. They almost certainly will NOT discontinue chemo, especially since it has been somewhat effective at suppressing the liver/lung mets and thusly extending his life.
Some healthcare systems, and US insurance companies, will say, "There has been progression (the recurrence of the primary) so this regimen isn't effective and we won't pay for it any more."
To which I say, "Stopping these drugs isn't the answer; adding MORE drugs to them is the answer; find something that STOPS my disease."
That is why I'm now on the supercocktail noted in my signature, and it's what suppresses my tumors and keeps me alive.
Very, very expensive. :shrug:
4. BIL needs to speak with an oncology surgeon, preferably one who is board-certified for colorectal cancer. That's the only individual who can evaluate the possibility of additional surgery at the primary location. Rather than a resection, perhaps a permanent colostomy and removal of lower colon/rectum is feasible? I dunno, that's for the surgeon's skill to determine.
But again, the system/insurer may say, "Because of the OTHER inoperable tumors in the lungs/liver, it is not cost-effective to operate on the colon again since those other tumors will eventually prevail."
5. Your BIL has been fighting this for 2 years, about the same as me though I've had no surgery. I'm no longer working nor as strong as your BIL, so he has a lot to live for yet.
I was originally told I had about 6 months, which was then changed to 2-3 years; I've now made the 2 years, and every day is a golden bonus.
If this is indeed a point in his cancer 'journey' where 'cure' is no longer a goal, then indeed it's time for 'palliative care:' Develop a chemo regimen that extends life without undo debilitating effects, and other medications and procedures to make life comfortable.
By no means is it time to shuffle-off to a shack in the desert and just waste-away to nothing.
God bless your concern for your BIL.
HTH,
-Rick