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Surgery for vein thrombosis?

My 80 year old dad, who lives in Mexico, was diagnosed with lung cancer in August. It had already spread to the lymph nodes, so his only treatment option (as described by the oncologist) was chemotherapy, but that it wouldn't cure him, just prolong his life. He opted to only treat his symptoms instead. He saw my uncle go through chemo, and he doesn't want that for himself. Until this, my dad was in admirable shape (still doing yard work, and fixing things around the house). He tends to have high blood sugar, but he's very careful with his diet. He's lost a lot of weight, so right now he's under-weight (5'5", about 120 pounds.)

He's been OK, considering, but during the past couple of weeks, one of his legs has started to swell. At first, the doctor (GP) thought it was lymphatic fluid, so he gave him diuretics, and Paxil (75mg a day). They didn't seem to help (he stopped the diuretic.) Right now, one leg is about 4in thicker than the other, and the swelling goes to above the knee (maybe mid-thigh.)

Yesterday, he went to another doctor, who referred him to a vascular surgeon. The surgeon told him that what he had where clots in his veins, and that given his condition (not sure if he meant the cancer, or what), the best option was surgery.  Furthermore, he needed to have that surgery today (because he was going away on holidays until next Friday.) After talking it over, and looking online, my dad decided to wait for a second opinion, which he plans to get tomorrow, or Tuesday (tomorrow is a holiday in Mexico) with another vascular surgeon.

Being Mexico, I'm very skeptical of this doctor, who seems very eager to operate, without trying drug therapy first (which from what I read, should be the first course of action).

So, I would like an unbiased medical opinion. Are there situations in which surgery is preferable to drug therapy? Could this doctor be right? He seemed to think that drug therapy was more dangerous than the operation, could that be true?
1 Responses
2827584 tn?1340579696
Sorry to hear of your father's misery. I assume that he was referring to a thrombectomy which means to remove the clot through a catheter. Acutely, this has been fairly successful in relieving the obstruction and restoring flow but it sounds like the clot has been present for a while in your father. Standard treatment would be compression and anti-coagulation. Most physicians would error on the side of conservatism in a patient with known metastatic lung cancer.
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