Elderly Mom has cancer. Any advice on treatment options?

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Elderly Mom has cancer. Any advice on treatment options?

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My mom, age 83, has breast cancer. Turns out she found the lump almost 5 months before seeing a doctor (this is typical behavior for her).

She is adamant that she does not want chemo, but is willing to have a lumpectomy and radiation. My sisters and I support her decision against chemo, but my father lost it when she initially said that. I'm afraid he will pressure her to have chemo if they give her a bad prognosis after surgery.

Does anyone have experience with an elderly person getting chemo? Also, any experience with an elderly person and lumpectomy, mastectomy, and radiation?

My mother had an aunt who went through the mastectomy and radiation in her 80's and had a ROUGH time of it.

Cancer Care Decisions Chemotherapy Treatment

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Xena, I'm so sorry to hear this.

What treatment has your mom's oncologist recommended? Not all breast cancers are the same and it's not like all of the respond to chemo. And not all chemo is the same.

Is someone going to the oncology appointments besides mom and dad? Taking along another set of ears could be very helpful.

My mom had breast cancer at 65. My dad was so hysterical, he couldn't hear anything the doctors were saying.

My parents, who were very smart, rational people BOTH became emotional basket cases. My mother almost made a very poor treatment choice just to get the surgery over with because she couldn't bear how my dad was behaving.

((((Hugs))))).

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XenaJada, so sorry to read your Mom has breast cancer. Do you know what stage?

If the cancer is only in that one breast and is a very low Stage, have Mom ask her doctor if he/she thinks doing mastectomy might be a better choice. I know for myself, I had a mastectomy 13 years ago and didn't need chemo or radiation, but did have to take pills that I had trouble with side effect.

This can vary from patient to patient.

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yes, i have a friend whose mother (83) did chemo (breast cancer). very bad idea. she suffered a lot, lived some months, then died.

my friend tried to warn her mother not to do it. but the doctor pressured her. after her death, the doctor apologized to my friend: chemo was the wrong decision.

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My feeling is that most doctors take it over the edge with the elderly, why put a woman that age through Chemo?

What to possibly live another 6 months and suffer all the way through it?

Today, it is all about money, how much can you get from Medicare?

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She has seen too many people in her community (far younger and healthier than her) suffer horribly through chemo.

She just witnessed her pastor turn into a shell of his former self over the past 2 yrs with chemo and then die. One of her close friends has been battling lung cancer and getting chemo and having a rough time.

I accompanied her to her first oncologist appt this week. Dr asked her what she was willing to tolerate as treatment. She said NO CHEMO. He said most elderly say that. He did not push her at all.

She has good insurance.

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My mother had breast cancer at 68, had chemo, radiation and a mastectomy. She had a hard time with the chemo, hated it, and it seemed to be a factor in other things going wrong (right now I can’t remember the list, but she was in and out of hospital many times over the next 10 years). Aged 78, the cancer came back with major metastases all through her belly. The oncologist did a major operation, which took most of the pleasure from her remaining 4 months of life (as well as costing a fortune).

When she had basically got over the worst of the operation, the oncologist wanted to put her on chemo again. The oncologist and the physician had a vocal argument in the corridor outside her hospital room. Later I asked the physician to give an opinion to us both about how long she would live if she had the chemo. He said about another 6 to 8 months, most of which would be taken up with the chemo. She immediately opted to stop treatment and go home. I moved in with her, and she died 4 weeks later. It was her choice, and best for both of us.

I don’t know if the oncologist was just greedy for lots more treatment, or whether she simply couldn’t cope with death and ‘giving up’. I think now that the operation at 78 was the wrong choice, because it achieved nothing but more suffering. I still have a lot of doubts about that oncologist, in spite of her professional reputation, and I wish we hadn’t been so trusting.

In your shoes, I would suggest a second opinion, and from someone who would be willing to criticise your oncologist. Best wishes at a time which is and will be very difficult, Margaret

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My dad had an operation and then chemo at age 91. His mind, though fine up until then, was never sharp after surgery, and the surgeon told me that Dad could try chemo but it would be very hard on him. We then talked to the oncologist, who said the same thing and made dad aware of the difficulties. Dad decided to try it, but it almost killed him. So he and the oncologist decided it was time for hospice.

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Xena, I am so sorry to hear about your moms diagnosis.

I would ask her and the doctor if a lumpectomy isn't going to get the cancer, can they make the change in surgery to mastectomy. This would be my only concern with her choices, that they just close her up if the lumpectomy isn't sufficient.

Are they going to do any tests before surgery to see if it has spread?

My sister had a cat scan and she was full of cancer, the breast cancer had spread, yet the oncologist wanted to give her chemo. Thought she would live 7 to 8 weeks with treatment. She lived 10 without and wasn't sick as a dog. So I am happy to hear your mom isn't being pressured.

May The Lord touch her body and give all of you peace and strength for this journey.

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If you want to learn and have a clearer and better understanding of the various Breast Cancer types and treatment options - I would strongly recommend www.breastcancer.org website.

The tumor size, hormone receptor type and any positive lymph nodes are factors used to stage breast cancer. A smaller tumor that has not spread may be removed by lumpectomy versus mastectomy which is no longer encouraged except for large tumors over a certain size. Sometimes in older patients they may not even do radiation treatments - just surgery tumor removal. Mastectomy is not always recommended.

My mother and MIL BOTH had a breast cancer tumor removed by lumpectomy - NO other treatments. My mother was age mid-70s and MIL was age early-80's. My mother is alive in NH at age 95. MIL passed at age 88 from other complicated health problems.

I was dx at age 49 with stage 2 breast cancer in 2006. Back then, if you had 1 positive lymph node you automatically got chemo. TODAY treatment protocols have ADVANCED with Oncotype testing to determine if chemo would benefit the patient. That testing was not available back then. Now SOME patients with a particular type of breast cancer can have 1 - 3 positive lymph nodes - AND with the Oncotype test confirm they may avoid chemo.

Do not jump to any conclusions yet - HOWEVER, I do agree that chemo is NOT an easy journey for some patients.

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Respect her wishes imo. Even if she does survive the chemo it will be an excruciating process from someone so old.

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Sisters and I intend to respect her wishes. I don't think my father will respect her wishes though, which is the problem. He is her POA.

I'm just PRAYING that the lumpectomy and radiation will buy her a few years. I lost a relative to lymphoma a few years ago and watching her go through chemo was horrible.

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Xena, POAs have no ability to force treatment unless the principal has been found incompetent.

What are you worried dad will do?

My dad, worried to death, angry at mom for being ill (he had chronic leukemia and was supposed to be "the sick one") nagged her about going to a better hospital, which she resisted mightily. It also turned out that my mom hadn't told her closest niece (her lifelong confidante) OR their lawyer who was also a good friend about either of their cancers.

I told the important parties which resulted in both parents getting more support. I convinced mom to go to the better hospital. Everyone was very angry at me for a while, which was fine.

You may need to step in to shut down whatever your dad is doing if it hurts mom. ((((Hugs)))).

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I'm worried that he will pressure/guilt her into having chemo. She was already softening her stance on it the other day, which tells me he has already been working on her.

According to her pathology report, she has an aggressive type of cancer.
She also ignored the lump for months. I have an expectation that it will be found in her lymph nodes.

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If the cancer is localized, I would do a lumpectomy and radiation. I would not do chemo. There is a pill but it does have its side effects. So does chemo and can be lifelong side effects.

My sister had an aggressive breast cancer. She went thru aggressive treatment once a month. The other 3 weeks just about the time she was feeling better, another treatment. She went thru this for 8 months and couldn't work during that time. Went back to work in June, started having pains in her back in Sept, found in October that the cancer was back. This was on a Friday she passed the next Tuesday. She had a breast removed and was 43. I have always wondered how long she would have lived without the chemo. This was 26 yrs ago and seems things have not changed other than now there is a pill.

I would not put Mom thru chemo. Its big money and only the doctors and pharmaceutical companies profit from it.

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XenaJada, could you get your Dad to read some of the responses to your issue, including my own. Some people seem to think there is something noble about ‘fighting cancer’, ‘putting up their best fight’ and all the other platitudes they use. Some doctors think that they ought to pursue every possible treatment. Death comes to us all, fight or no fight. Love means making it easy.

Could you get him the great book "Being Mortal" by surgeon and author Atul Gawande. It’s fairly specific to cancer, and has helped many people.

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If the cancer has spread i can't see the point of mom putting herself through a lumpectomy and radiation. She should have a serious talk with her doctor about quality of life versus quantity. Radiation is no picnic either. I think its like 6 to 8 weeks of daily radiation. Plus she should be asking how long those two things would buy her in regards to life expectancy. If it is a few extra months it may not be worth the surgery and radiation.

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Radiation will be bad enough with the burns, so chemo would be just that much worse.

My aunt was forced into chemo for multiple myeloma by her hysterical children, and she lasted two weeks on it before she said enough is enough. My cousins all regret pushing her into it, but they just freaked out when she was diagnosed and gave no thought whatsoever to her quality of life as a nearly 90-year-old on chemo. She lasted another month or so after she quit.

Most doctors will back you if you really want to try all the treatments, because who's going to tell you it's futile unless you're just riddled with it. That doesn't mean it's the best decision, but acting on your dad's hysteria is not the way to make a decision either. Mom gets to call the shots on this one.

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Today there are 3 types of Radiation Therapy options available to the patient besides the traditional 6 week course. However, these newer treatments may likely only be offered at a larger based medical facility with specialized advanced treatments offered.

https://www.breastcancer.org/treatment/radiation-therapy

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Both my grandmothers had breast cancer when they were well into their 80's. They both opted for lumpectomies and then radiation. Neither were offered chemo, as they drs felt that surgery + radiation was sufficient.

Both lived another 10 years, and neither died of breast cancer.

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1. What stage of breast cancer does your mom have?
2. What type of breast cancer?
3. Has it spread to her lymph nodes?
4. Has she had a biopsy? if so, how large is tumor?
5. Did she have an ultra sound? if so, was it in lymph nodes?
6. Where does your mom live?
7. Where she lives is there a Cancer hospital or Cancer Center? if so, whats the name?
8. Does the cancer facilities come highly recommended?

You have to help your mom build a team of doctors who work together to come up with a medical plan who all work together & communicate with each other. You will need a Breast Disease Surgeon, a Plastic Surgeon, and a Oncology Doctor. If your mom has a gynecologist they should be included with medical reports etc.

On the report it should state if its DCIS, LCIS, IDC, or ILC. It should state on report if it is Invasive or noninvasive breast cancer .
Please respond back

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I think you asking for these personal medical details is crossing the line regarding patient privacy for HIPAA law.

https://www.hhs.gov/hipaa/for-professionals/privacy/index.html

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One day at a time here. She starts with the lumpectomy and possibly other scans. Then she gets to speak with the onchologist. Your family is over thinking too far ahead. Listen to the specialists. I can say that lumpectomies, which I had several, is easy but still nerve racking. Good luck. Please listen to her choices.

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From personal (my mom) experience, the only advice I can give is to ask the docs to give you honest, real, raw information about what it will be like for her and what life will be like afterwards. Many elderly suffer more just to be kept alive, with severely diminished quality of life after treatments. I wish you all peace with whatever you decide to do.

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ONE
........ STEP
................... AT
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(like what I did there😉)
Any surgery for an older person is difficult.
The lumpectomy makes sense. Then see what happens next.
What happens if she does not have further treatment?
What happens if she does?
Does she have any other medical conditions that would effect treatment options?
Knowing what I know now....I probably would not have insisted that my Husband have a cancer removed. I think the process of having the surgery caused a decline that would have come later. But..20/20 hind sight is a wonderful thing. then again it m ight have made no difference in the outcome at all... Who knows!?

Bottom line I would respect mom's wishes and encourage others to do the same. The important thing is being supported in any decision you make. Discussions are one thing, coercing, is another.

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Respect her wishes. It’s her body and her decision. The quality of life during chemo is horrible.

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I would be making the same choice for myself as your mother has. I am about her age.

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I think your Mom is making the right decision. I myself would do just what she is doing; I am 80. I am a retired RN and a cancer survivor of 36 years now. I have not had mammograms for 2 decades and do my own self exam on my remaining breast monthly. I found all my own lumps both benign and malignant, and the lump that was cancerous was in my armpit and did not show on a mammogram nor the primary in the breast.
I took adjuvant chemo for 6 months and refused radiation 36 years ago. One chemo was infused and the two others were pill form; most of them ended in landfill at the time.
Your Mom should make her own decisions and I would say basically shame on your father for trying to make that otherwise.
We all die of something, and let me tell you that overall, those who die with cancer get good pain relief and hospice at end of life now while those suffering dementia and losses one cut at a time through aging are less lucky in my book. I fear cancer less than just about anything out there other than a weak heart that might take me instantly.
Chemo can kill. Let your Dad know that. It is very destructive to the body. He needs to honor his wife's decisions for herself as she should honor his own for himself.
My opinion only, but heaven help the person who interferes with my decision. The amount of advice and directions whether by well meaning friends or doctors themselves is confusing enough without the input of a frantic husband. He needs to stand strong for his wife's decision. This is her deck of cards. Let her play them as she sees fit. And the very very best of luck. As an RN I played my own cards years ago. That I happened to win THAT hand doesn't mean that I won't get the game I can't win. We all are going the same place. That I am 80, raised my children, had a life, did what I wanted, makes me feel very very lucky indeed.

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I think you might be able to help by sitting down with just Dad and telling him you want Mom around for another 10-20 years too which is actually why you aren’t convinced chemo is a good idea. You have done some research and from what you have learned at her age chemo more often either kills or greatly lessens quality of life from the rigors of chemo than opting not to do chemo. People live happier longer without chemo after 80 (I’m guessing here). Then ask if you can go to the next appointment with her oncologist or surgeon whichever you think best, where you can ask the questions about treatment prognosis vs non for each step and help you all make an informed decision.

Your dads reaction is based on love and fear, just like yours is but he doesn’t think about your mom being 83 he thinks of her a 60, he doesn’t think about himself being 80, he feels as sharp
and vital as he was when he retired, whether or not he/they are.

Rather than trying to convince him chemo isn’t a good idea go on the journey with him to educate yourselves and make an informed decision. Be their partner and let them make you an advisor rather than feeling like your imposing (I can’t find the word I want, of course you aren’t imposing) your views on them. You may find that radiation isn't needed or worth it too and don’t be afraid to get a second opinion. You are more likely to get results if you help guide them than you are trying to convince or plead with them. Give Dad time to let things sink in too. Sending good thoughts and energy to all of you as you go through this.

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My sister came up clear of cancer after her mastectomy. Think she did do radiation but be aware, it burns the skin and causes paint/discomfort. She was talked into chemo because the cancer was a fast growing mass. There maybe that one little cancer cell. She passed almost 1 year after being diagnosed. My question always was, would she have survived just as long if she had no chemo. Chemo kills the white blood cells too making the person susceptible to other infections. Your Dad should be supporting her decision.

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XenaJada, I would like to encourage you to get mom some emu oil to put on the Burns from radiation. It is AMAZING for taking the pain out and helping heal. I keep it in my 1st aid kit for burns, bug bites (takes the itch out) and skin injury.

I really recommend Montana Emu Ranch Co. They do it according to safe standards and keeping the oil from going rancid. Get her a 4oz bottle because any left can be used for a face moisturizer or kept on hand for 1st aid.

How are you coping? Big hug, I can't imagine how challenging this is for you.

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Let her decide.........she's the captain of her own ship.

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She’s competent and knows what she wants. She’s seen the misery it can cause. Can you accompany her to her doctor and ask questions—there may be questions that your mom has never considered. What stage is it? Get a second opinion—not all doctors are created equal. Google breast cancer in the elderly to educate yourself. Keep in mind that doctors are about treatment and fixing, not necessarily the patient’s well being. I had to go through similar decision making for my brother with brain cancer. I elected quality of life in his situation even as doctors pushed treatment. It’s not unusual for families to have a reaction like your dad’s. Your mom, sister and you are facing death but your dad isn’t. He’s afraid so he wants to do everything without knowing the consequences on her mom. One book that really helped me was ‘Being Mortal’ by Atul Gawande.

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My sister had the same scenario during Covid and the oncologist and surgeon told her they recommended being the nature of the cancer being early stage. And radiation not chemo due to that. She was 82 and she has no regrets as it was much easier going thru it out patient for the surgery and able to come home with me and I took care of her and took her to radiation. She went in the morning for radiation and I took her and then came home and slept for a few hours because it takes all your energy but nowhere near what chemo does. I wish her good luck and please give her lots of support because going thru this in your 80’s is scary..

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My mother is 84 and about to have major surgery to remove a leiomyosarcoma (smooth muscle tissue tumor) near her left kidney and the staff at the treatment center seem to be more focused on ensuring she gets the right nutrition and exercise to aide in her healing post surgery.

While I don’t have experience with an elderly person being treated for breast cancer, I went through my own journey from October 25, 2018 (initial diagnosis) to July 9, 2019 (oophorectomy). I know I’m a broken record, but everyone’s journey is different because of genetic makeup, physical health, and even mental health.

Speaking of mental health, it can play a very big part. My brother and I have to be cheerleaders now to encourage my mother to walk - even though we’ve been doing this along with her doctors for YEARS. Now I’m the parent- like everyone else out here - yelling from the sideline.

All the treatments are cumulative so she’ll gradually slow down from fatigue during radiation. I would encourage her to start moisturizing her chest regularly to combat the damage that radiation can do to her skin.

lastly, following her lumpectomy, if she has lymph nodes removed, encourage her to move her arm around as soon possible to avoid developing lymphedema. I can’t say for SURE, but I think me protecting my left breast from being jumped on by my animals may have been a contributing factor to me developing the condition; breast looked like an orange peel because the lymph fluid was not flowing properly.

I pray for you, your mother and the rest of your family; especially your father. I hope he is able to accept it’s her health and decision to make. While it impacts many, as we all know when you get older you start to regress and eventually relinquish control over some things - driving, where you live. And the only thing you may be able to control is your thoughts and decisions.🙏🏼

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Elderly Mom has cancer. Any advice on treatment options?

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