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My Dad had cancer and they removed it, but now he is worse off than before the surgeries. He is 78 y.o. He is too weak to have a ureter rebuilt or his gallbladder removed. Who should be the director of his care? The urologist, The Kidney Dr? He has constant diarrhea and feels like throwing up a lot. The Doctors really are not giving me a clear path ahead on what to expect or how long my Dad can go on in this condition.

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I am very sorry that you and your dad are going through this. The truth is no one can really give you prognosis. A lot depends on how healthy and strong your dad was before surgery. When I say strong I mean physically and emotionally. What kind of cancer it was? How fast the cancer grows? Did the cancer spread? There are a lot of factors to consider. I wish I could give you a straight answer.

Surgery is hard on most people at any age, but the older we get the harder the recovery is and it takes longer to heal.
Does your dad have a Health POA, if not and your dad is in the hospital you can talk to a social worker there. There are people on this forum that knows more about this than I do.
But I will tell you this, when my dad ever had surgery I asked the doctors every question I could think of and I didn't let them leave until I was satisfy with the answers. Of course, times were different than and my parents left all the medical chit chat up to me.
Is he still in the hospital? He can get dehydrated very quickly. You may need to be his voice or a sibling. My heart just breaks for the two of you.

May God be with you and your dad in your time of need. May He proved healing and strength in Jesus' name. Amen
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That is a question for his doctors; strangers on the internet, most of us just caregivers like yourself, can't possibly guide you. Studies show that there is often a disconnect between doctors and their patients when it comes to treating these kinds of conditions, when more time is promised with aggressive treatments patients envision years but often the reality is only months if that. The book Being Mortal by Atul Gawande is a wonderful resource when navigating these waters, Aging Care has an article that provides a shortcut to some of his thought provoking questions.

https://www.agingcare.com/articles/an-end-of-life-conversation-led-by-gawandes-questions-205721.htm

For a more in depth article google Atul Gawande's 5 questions
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It is hard to tell what should be done, as usually prostate and bladder are not removed at the same time, unless it was very advanced bladder cancer. It sounds like the gallbladder is causing problems with all the vomiting and diarrhea. It is difficult to answer these questions without labs and records. However, the urologist should be in charge of the urinary tract, and possibly a general surgeon for the gallbladder. I would take him to a university to have him checked out. He is weak, because having a cystoprostatectomy is a big surgery with blood loss. He should recover strength, making the prognosis easier to ascertain. Is he ambulatory and living at home? If he is in a long term rehab facility, you will have to watch him like a hawk. My family's experience with my Dad in an LTAC was a constant battle of justifying his life. They insisted he go into hospice for no physical reason other than their jusification saying "he has lived a good full life". It was actually horrific. I had to go in between one and three am to check on him, and discovered all sorts of purposeful malevolent behavior toward my sweet Dad. Have your Dad checked out by a well respected university staff. Good luck.
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I am assuming he now has a bag. It takes a while for anyone to recover from surgery. The Urologist takes care of bladder and prostate. Not sure where a kidney doctor comes in unless the cancer has spread. My Mom had bladder cancer in the tube from the bladder to her kidney. The urologist took her tube and kidney and small area of the bladder.

If they took your Dads bladder then the cancer must have gotten thru the bladder's lining and spread. Where they able too get it all. There are tests to find if it has spread. The gallbladder can be taken out thru 3 or so small incisions. So, I think your questions should be asked of the Urologist.
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