My farther, 64 yr old male. Hx of COPD , CHF, High Blood Pressure (controlled) was sent to ER where he was diagnosed with stage 4 throat CA. Hospital did emergency surgery, for his esophagus was 98% closed. Three days later they performed a total laryngectomy and 7 days later placed G-Tube. My father has elected not to proceed with radiation nor chemo . He has had rapid weight loss and his body would physically not be able to tolerate it due to malnutrition along with his chronic COPD. He is now showing signs of cognitive deficits. I have requested a MRI and CT of the brain to see what we are dealing with at this point. He has been in the hospital since 10/2/2012. They are currently providing extensive wound care for his fistula is not healing on its own, therefore continuous drainage throughout the surrounding neck area continue to flow with drain tubes. With this being said, I would like to know the realistic time frame my father has. I would like your professional opinion. His quality of life is not up to par and his cognitive status is deminishing slowly but surely. How long does it take for the cancer to spread to the brain and what realistic time frame are we looking at? Thank you