My ex wife father can't get a biopsy nececery to get Keytruda as oxygen levels 87%.

[Seasid]

My ex wife father 89 years of age has a metastatic lung cancer. Since short time ago he is in a hospice (paliative care). He is in Zagreb Croatia. His oxygen saturation level is 87%. (They can't rise his oxygen levels with supplemental oxygen.) The doctors can't perform bronchoscopy and can't get a biopsy nececery to get Keytruda. He is heavily sedated and probably comfortable. My ex wife is in Switzerland in Zürich and I am in Sydney so we can't help him. My ex wife tryed to communicate with the Croatian doctors in Zagreb but it failed. So she gave up. What would you do in this situation? I sugasted liquid biopsy but we are not sure if it is enough to get Keytruda in Croatia. We had the idea maybe to get a biopsy from the lung metastasis in an other organ. Unfortunately the doctor don't reply so we are in the dark. What would you suggest in such a situation? I would like to understand why can't they rise his oxygen levels with supplemental oxygen? Any idea?

[Denzie Moderator Volunteer]

Very sorry that your former father in law is doing so poorly. The only thing I can think of is that he may not have enough red blood cells to carry the oxygen to his body needs. I needed a transfusion of blood before I could begin treatment for my cancer.

A liquid biopsy should be able to tell you if he qualifies for Keytruda.

[Jenniferroseolson]

I am very sorry to hear this. In the US, palliative care and hospice care often occur within the same medical department but have differing goals/actions. They are not the same thing. Here, if someone is receiving hospice care, he must sign an agreement that indicates that life-saving treatments will not be continued at that point and the focus becomes comfort. If he is receiving palliative care, then professionals work to help him live a better quality with the side effects of treatment while the patient at the same time is receiving chemotherapy or immunotherapy or other efforts to cure the cancer. That seems a bit off topic for your question, but my thinking is this: if he is already on hospice care, he may not be able to seek a curative treatment unless he discontinues his hospice agreement. Best wishes for you all in understanding how best to help him.Jennifer

[Jamif]

My father could not get a good sample from brochoscopy, and also could not get a good sample with needle biopsy of lung due to it being collapsed. In the end he had a hip biopsy (where metasis was shown on his Pet scan). Those results were used to plan out his chemo and immunotherapy.

[Seasid in reply to Jamif]

Thanks, very helpful. I will forward this to my ex wife.