The Doctors (2) and surgeon (1) tell us this is how to treat her physical condition. They say at her age it’s major surgery. I’m having difficulty understanding why surgery when no medical professional will say she has cancer. Why the major surgery at 82 years old for a can’t rule out cancer reason. Rule it in or rule it out. Why can’t we be certain?
You say she's mentally unstable - how do you mean? Are you referring to some form of dementia, or a different sort of mental disability? Is she capable of making her own decisions? Or is she not capable, and you/another family member her POA/MPOA?"
Yes! Please give us more information!
I'd also like to know if your mother lives with you? You with her? What kind of caregiving do you do now? Besides full hysterectomy being a big surgery (and recovery!) for an 82-year-old, are you going to be the one to be the caregiving slave during that recovery?
It was after the surgery that everyone noticed she had some cognitive problems. Chemobrain is a real thing and is often caused by chemo. General anesthesia is another major risk factor for developing dementa. Two strikes! The confusion was probably there before but we were not as attentive as we were after the surgery.
Did the surgery give her a few more years? Who knows and for what? Eight more years of progressing into the depths of Alzheimer's. Cancer when we are older often progresses very slowly. Would that have been the case? Again, who knows. Knowing the dementia would have become so terribly profound it would have been a better idea to leave the cancer untreated. But, it was mom's decision, she was still considered competent.
And a hysterectomy is considered major surgery. I had one in my 40's and it was tough. Sponges were lost, the vaginal procedure became an incision so the doc could go sponge hunting. Anything could happen....
She did have cancer, but they were not 100% sure before the surgery.
Second opinion.
When a doctor says: "It could be cancer", they don't know.
You say she's mentally unstable - how do you mean? Are you referring to some form of dementia, or a different sort of mental disability? Is she capable of making her own decisions? Or is she not capable, and you/another family member her POA/MPOA?
NOT that I'm advocating for this 82 year old woman to have a full hysterectomy, but there are other reasons besides cancer to have this procedure done. Some background on what her symptoms are might put the question into better perspective.
This must be a difficult place for your family to be in. Best wishes as you decide what to do. But do keep in mind that doctors have a financial incentive to push such treatments, and it's not always in the patient's best interest.
Removing any organ from your body is major.
If the doctors are not giving a CLEAR reason
If the doctors are not giving a LOGICAL reason
Why this is being advised then back off..get another opinion.
What harm is there going to be if this woman waits another week, 2 weeks, or 6 months.
the big questions are...
IF there is cancer what is the plan?
Treat? an 82 year old? I don't think that is a wise move.
Don't treat? Great option given the age and mental capacity. But if you don't treat WHY do the surgery to begin with.
Your doctors are not giving you ANY answers that you NEED except to say it's 'major surgery' and that this is how it 'must be done.' With no reasons to back up those claims.
I call FOUL.
Either get the correct answers to your questions or find another doctor, and insist it be a woman who's doing the surgery ON your loved one who's a woman herself & needs a hysterectomy, maybe. And insist on knowing where the cancer is, how progressed it is, and if there are any other alternative treatments OTHER than surgery available. And then think long & hard before putting the woman through such a surgery, when she's 'mentally unstable' to begin with. Will extending her life (IF such a thing happens) be worth it? Does she want her life extended? Being mentally unstable, will she be able to endure the recovery process which WILL NOT BE A CAKE WALK, regardless of what man tells you it will be?
Also keep in mind that if cancer is present, there are absolutely NO GUARANTEES of anything, never mind 8-10 years of an extended lifespan! When my birthmother had surgery for uterine cancer, it wound up spreading to her ovaries and KILLING her in short order, rather than 'extending her life'. She would have been better off leaving the uterine cancer ALONE than listening to her doctors telling her how easy-peasy it was to 'just operate' on the uterus and 'remove it all' that way. Yeah, huh? Pure B.S. that turned out to be. All bets are OFF where cancer is concerned, IF cancer is at play here with your loved one.
Please demand ALL the facts before you can make any rational decision.
Best of luck to you.
So much for ratings.
If that person isn't available, ask if another medical provider in the oncology office can talk to you, a nurse or a PA. If you don't get anywhere that way, talk with your mother's regular doctor or PCP about a strategy for figuring this out. When you do sit down with someone who can put this together with you, include a friend or a relative in the conversation so that they can take notes.
I can understand your dilemma very well. My father has a tumor in his leg, which was discovered at the end of 2020. We were referred to an expert in orthopedic oncology. She was all for taking it out although she thought it was 50/50 whether it was a cancer or a benign fatty tumor.
He was 92 at the time. I got a second opinion at the university medical center and that orthopedic oncologist said he didn't think it looked like a cancer yet (although it could turn into one at some point) and that he should have regular MRIs to follow it.
This doctor left and we met the new one in April. He did not say anything about cancer. He said definitely not take it out no matter what. I didn't like that (too long to go into why) so I talked to his PCP and she agreed Dad should get another opinion on surgery. That oncologist said without missing a beat that it was cancer. She didn't know how aggressive. She too said not to take it out.
Here I was with one oncologist saying nothing about cancer and another saying he had liposarcoma, each having looked at the same MRI. I was ready to do what I tend to do -- flip my lid and chew out both oncologists. Instead, I got his wonderful PCP involved. I asked her to talk to both oncologists to make sense of this. As it turned out, the ass oncologist at the university does think it's cancer but a low-grade type. He says we should keep an eye on it with MRIs.
I called the assistant to the original oncologist who wanted to take it out right away and asked her if the doctor could look at the series of MRIs done over the last year and a half. She said she would but I haven't heard back from her yet so I'll have to call her this coming week.
I told Dad this was his decision and I went over everything with him. He asked my opinion. I just don't know yet. Once I get the original oncologist's opinion, if I do, I'll drill down on the pros and the cons.I have just enough medical knowledge to be stupid but I'll do the best I can. Then I'll run my rationale past his PCP.
So, if there's time to, come up with a strategy for getting the facts explained to you in a logical way. The missing piece in my father's case was the idiot oncologist at the university. Nothing is 100%, so do the best you can and get any help you need. Best wishes.
What symptoms are your mother having? Does she have a prolapse? Often a vaginal hysterectomy can be done quickly. I would get thorough information about exactly' A) what condition are they dealing with B) what are the repercussions of not having surgery?
A hysterectomy in an 80+ woman is MAJOR surgery and no fun to recover from.
There is no excuse for a drs not finding a positive cancer DX. Sheesh, a simply PET scan and she'd glow light a Christmas tree! Non invasive and simple.
I'd be really, really hesitant to go with a dr who cannot give a clear dx but is willing to perform this surgery on her.
And, does she WANT 8-10 more years? When/if my cancer comes back, I am not treating. And I'm only 65!
1-The uterus and ovaries are the sites of many types of deadly gynecologic cancer.
2-The uterus and ovaries in an 82 year old woman are useless organs.
3- If there is a suspicion of cancer, it's better to get the uterus and ovaries out without waiting for cancer confirmation, because by that time, it could be too late.
4-In regard to the surgical risk, removal of female reproductive organs can be performed nowadays by laparoscopy surgery, which is a minimally invasive procedure. Very safe, less traumatic and with a short recovery time.
5-In regard to the anesthesia, it could be performed with spinal anesthesia, which avoids general anesthesia.
Not having surgery would allow a potentially treatable cancer, to kill the patient within a short time.
6- A successful surgery would guarantee at least 8-10 additional years in her life span.
You have to do what you feel is best for her. I wish you the very best in figuring out exactly what that is.
Are you your mother's PoA? Or legal guardian? At 82, that is a very major surgery for sure. Even the after effects of the anesthesia, and UTIs from being catheterized will add to her recover burden. Do you think she will willingly comply with her post-surgery self-care? If not, then maybe consider other options, like hospice. More information would be very helpful so that the many seasoned RNs on this site can provide you with the best guidance.