What to expect

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What to expect

by EmmaAus on Tue Nov 18, 2008 12:00 AM

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Hi, my grandmother (now 84) was diagnosed with breast cancer 2 years ago and had a radical mastectomy on her left side.About 2 months ago she started complaining of pain whilst urinating and after a month of her doctor saying don't worry about it it's all in your head (i should mention at this point she also has dimentia) my mum finally took her to another doctor and after a few tests they discovered she had kidney cancer. She has been to oncologists and they recommended Chemo and Radio therapy. Now, they have discovered 2 lumps in her breasts and another cancer in her colon. I have had mixed messages from people some saying that she should still continue and start the treatments next week and other who say, it's too aggressive and with the age and dimentia as well we should just let nature take it's course. I am really after some words of wisdom from anyone who may have had to make this choice before and anyone who may know life expectancy rates in this situation. I would rather have a month or 2 of her here, with pain medication and her happy than however long it may be going through the pain of chemo (which i witnessed my mother go through when she had breast cancer 10 years ago). I am just so confused. Can anyone help?

RE: What to expect

by trehouse60 on Tue Nov 18, 2008 12:00 AM

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On 11/18/2008 EmmaAus wrote:

Hi, my grandmother (now 84) was diagnosed with breast cancer 2 years ago and had a radical mastectomy on her left side.About 2 months ago she started complaining of pain whilst urinating and after a month of her doctor saying don't worry about it it's all in your head (i should mention at this point she also has dimentia) my mum finally took her to another doctor and after a few tests they discovered she had kidney cancer. She has been to oncologists and they recommended Chemo and Radio therapy. Now, they have discovered 2 lumps in her breasts and another cancer in her colon. I have had mixed messages from people some saying that she should still continue and start the treatments next week and other who say, it's too aggressive and with the age and dimentia as well we should just let nature take it's course. I am really after some words of wisdom from anyone who may have had to make this choice before and anyone who may know life expectancy rates in this situation. I would rather have a month or 2 of her here, with pain medication and her happy than however long it may be going through the pain of chemo (which i witnessed my mother go through when she had breast cancer 10 years ago). I am just so confused. Can anyone help?


Hi EmmaAus,

As a cancer survivor (endometrial cancer 2002 - cured) , a person living with cancer (breast cancer 2002, diagnosed with metastasis to lungs 2008), , and one who has lost both my best friend and my mother to cancer, if I were in your grandmother's shoes, I would say "No chemo, no radiation. Treatment using naturals  if they will help me to not have pain and to otherwise keep me as healthy as possible. Prescription drugs only for management of pain, and to keep me from having infections.  Let me enjoy the rest of my life, and when it's my time, help me to pass on with dignity."

Speaking as a former RN and one who has done a lot of research on using alternatives to treat breast cancer: I'm not sure there is any major advantage to chemo/radiation at this point. Leading authorities on breast cancer are increasingly coming to believe that by the time they reach their early 80's, MOST women will have at least early breast cancer. Therefore there have already been some studies on breast cancer in the aged; most of what I've seen published indicates that for these women, there is no increase in life-span gained through chemo or radiation therapy. In fact, there is a lot of evidence that at this age, women who choose NOT to have treatment outlive those who get chemo or radiation.

So in terms of "quantity" of life - maybe no advantage to treating the cancer.

Thus "quality" of life becomes the main issue. With dementia, especially if it gets worse, your grandmother is already at risk for decreased quality of life.  She may have skin care problems - chemo/radiation might make that worse.  She might have nutrition problems. Chemo/radiation will DEFINITELY make those worse.  Treatment - especially if she is given steroids - is likely to interfere with her mental functioning: increasing forgetfulness, disorientation, possible "brain fog" from chemo. 

As for pain, that can be treated without chemo/radiation, especially if you use natural alternatives in combination with  prescription drugs. 

That leaves the question of kidney and bowel function.  Yes, eventually the metastasis is likely to cause kidney failure, but that may take a very long time. And the dementia could take her first. I would ask the dr how likely it is that she will have problems with blockages of urine and/or the bowels in comparison to how long before she might start having life-threatening problems from the dimentia, and if pain from the cancer is likely to become a major problem before the dimentia becomes life-threatening. If a short period of chemo  or radiation could significantly lessen the risk of these two factors, then perhaps I would consider going ahead with them.

The other thing to consider is how bad is your grandmother's dementia.  If she is still at all capable of making decisions, I would certainly find out what she wants to do about all of this.

In the end, you and your mum (and whoever else is part of the decision making process) need to go with whatever gives you the most peace in YOUR hearts, regardless of what any outsiders might say. This will enable you to continue caring for your grandmother with love and kindness, and those are the most important gifts she could receive. 

Sincerely,

Tre

RE: What to expect

by trehouse60 on Tue Nov 18, 2008 12:00 AM

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I forgot one thing.  This is an excellent article from a Hospice organization on  end-stage disease - I think it may help with the decision making processs, and it most certainly might be worth reading later on down the road:

http://www.virtualtrials.com/btlinks/death.cfm

For you and your mum as you go through this, please take good care of yourselves, so that you can be of the most help to your grandmother.

Sincerely,

Tre

RE: What to expect

by Leemg on Tue Nov 25, 2008 12:00 AM

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I recently found out that a lady who worked with my husband in her mid 60's was diagnosed with a lung nodule.  A mammo and physical exam revealed many breast lymphs.  She was to go in to have a biopsy.  Over this past weekend it was found that she was also in kidney failure, not sure whether the cancer had also affected the kidney but once she is released from the hospital the doctors recommended Hospice.  This tells us she has less than 6 months probably much less considering she is in kidney failure.  Actually, this will be a blessing as she may not have to suffer as long.  I understand she is now experiencing pain.  I would say that your gran is probably in an equal situation and her kidney will also start to fail.  Considering her age and the severity of her disease I would do whatever necessary to make her as comfortable as possible. 

RE: What to expect

by baby_girl609 on Thu Dec 04, 2008 12:00 AM

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I am 34 years old . I am also a mother of 4 I was just diagnosed with breast  cancer . I am scared I need to find a local support group. To help me cope I live in Pleasent ville N.J  If anyone knows of any local groups please let me no I feel so alone .I am willing to fight this thing but it helps to no that I am not alone.
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