My 71 year old brother was diagnosed in Jan with stage IV kidney cancer. We found out last week he has 11 percent kidney function and the cancer has spread to both lungs and his bladder. Today he is so exhausted he can not get out of bed. His hands are so swollen the skin is breaking. He has an appt Wed at the VA Hosp (140 miles away) . Should we wait till Wed. Or try and convince him to go to the ER today? Is this just a normal progression of the disease?
Thanks for your question on Chat Doctor. In my opinion you should definitely take him to the hospital. As he may any time go in renal shut down since only 11% kidneys are working. Bilateral upper limb edema suggest worsening of renal function and spread of tumor in lymphatics. So he may need renal assistance and renal replacement therapy.  And this can only be done in hospital. So take him immediately to ER. And yes, this is usual progression of the cancer.