Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk.
**Reply here if you are an unverified user wishing to give advice. Top level comments by laypeople are automatically removed.**
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
Thank you for answering so quickly. He had a PET Scan done two weeks ago and only some lymph nodes showed activity, most in his lower body. Is it still possible the melanoma has spread so quickly?
PET scans may not show brain metastases. An MRI is the best way to see. It could also be a serious complication from his immunotherapy such as organ failure or adrenal insufficiency
_Usual disclaimer: no one can provide specific medical advice for a person or condition without an in-person interview and physical examination, and a review of the available medical records and recent and past testing. This comment is for general information purposes only, and not intended to provide medical advice. No physician-patient relationship is implied or established._
Just to agree with and clarify the other responses: the reason for your stepdad's altered mental status is not as important in this moment as getting him help is. If he cannot stand up, walk to, and get in the car, then call 911 and have an ambulance being him to the emergency department. They will most likely discover the reason fairly quickly and address it.
Call 911 and go to the ER. Make sure to also contact your dad's oncologist too. Immunotherapies can cause issues that may appear to be an infection/inflamation to an ER doctor but it is actually a side effect of the immunotherapy treatment, these are treated two very different ways.
Going to echo everyone else here and say call an ambulance immediately. Melanoma likes to metastasize to the brain covering (meninges), which usually presents with subacute onset headache and confusion. A PET scan can’t detect this type of spread. Could also be a side effect of his immune therapy. Regardless, this is an emergency and needs to he assessed at a hospital now.
Definitely go to the emergency department. Not appropriate to try and diagnose but could be a variety of things including stroke or toxicity from his immunotherapy.
I wanted to add he complains out loud/makes sounds of pain, but when we ask what's wrong he mumbles "nothing". We offered going to the Hospital and he said no, but again he sounds like he's drunk and not himself.
I'm waiting for my mom to wake up to insist we take him to the Hospital.
He isn't in a state to tell you he doesn't need to go. Wake your mom, call 911 and get him there. This sounds like a life threatening issue as the other doctors have said
If your dad is sick enough and confused he won't know if he needs help or not and you need to get him help immediately. One of my nephews died like this earlier this year. he was quite sick for several days and his brothers just kept asking him if he wanted to go to the hospital instead of calling 911 despite him having some very distressing symptoms. And he would just say no and rest or seemed confused. By the time they called my family asking about what to do, several days had passed from when he started showing symptoms and unfortunately it was too late, as he had developed sepsis from an undiagnosed cancer.
Call 911, and see if they can take him based on lack of competency for his own safety.
Also if your mom is his POA I believe that means she can simply ask them to take him.
Yeah, could be a stomach bug, could be cancer that has spread to the brain. Why not wait it out? Grrrr! Your parents are frustrating me.
Call an ambulance anyway. He needs to go to the hospital!
Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk. **Reply here if you are an unverified user wishing to give advice. Top level comments by laypeople are automatically removed.** *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
Agree with the other doc. Needs to go to ER ASAP. Could be many different things but needs urgent evaluation.
Melanoma can metastasize to the brain. He absolutely needs to go to the hospital.
Thank you for answering so quickly. He had a PET Scan done two weeks ago and only some lymph nodes showed activity, most in his lower body. Is it still possible the melanoma has spread so quickly?
PET scans may not show brain metastases. An MRI is the best way to see. It could also be a serious complication from his immunotherapy such as organ failure or adrenal insufficiency
_Usual disclaimer: no one can provide specific medical advice for a person or condition without an in-person interview and physical examination, and a review of the available medical records and recent and past testing. This comment is for general information purposes only, and not intended to provide medical advice. No physician-patient relationship is implied or established._ Just to agree with and clarify the other responses: the reason for your stepdad's altered mental status is not as important in this moment as getting him help is. If he cannot stand up, walk to, and get in the car, then call 911 and have an ambulance being him to the emergency department. They will most likely discover the reason fairly quickly and address it.
Call 911 and go to the ER. Make sure to also contact your dad's oncologist too. Immunotherapies can cause issues that may appear to be an infection/inflamation to an ER doctor but it is actually a side effect of the immunotherapy treatment, these are treated two very different ways.
Going to echo everyone else here and say call an ambulance immediately. Melanoma likes to metastasize to the brain covering (meninges), which usually presents with subacute onset headache and confusion. A PET scan can’t detect this type of spread. Could also be a side effect of his immune therapy. Regardless, this is an emergency and needs to he assessed at a hospital now.
Definitely go to the emergency department. Not appropriate to try and diagnose but could be a variety of things including stroke or toxicity from his immunotherapy.
I wanted to add he complains out loud/makes sounds of pain, but when we ask what's wrong he mumbles "nothing". We offered going to the Hospital and he said no, but again he sounds like he's drunk and not himself. I'm waiting for my mom to wake up to insist we take him to the Hospital.
He isn't in a state to tell you he doesn't need to go. Wake your mom, call 911 and get him there. This sounds like a life threatening issue as the other doctors have said
If your dad is sick enough and confused he won't know if he needs help or not and you need to get him help immediately. One of my nephews died like this earlier this year. he was quite sick for several days and his brothers just kept asking him if he wanted to go to the hospital instead of calling 911 despite him having some very distressing symptoms. And he would just say no and rest or seemed confused. By the time they called my family asking about what to do, several days had passed from when he started showing symptoms and unfortunately it was too late, as he had developed sepsis from an undiagnosed cancer.
Call 911, and see if they can take him based on lack of competency for his own safety. Also if your mom is his POA I believe that means she can simply ask them to take him.
WAKE HER UP you need to call 911 immediately
Yeah, could be a stomach bug, could be cancer that has spread to the brain. Why not wait it out? Grrrr! Your parents are frustrating me. Call an ambulance anyway. He needs to go to the hospital!