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Topic: Healthy 86 year old wants to refuse radiation

Forum: Just Diagnosed — Discuss next steps, options, and resources.

Posted on: Mar 25, 2009 12:53PM

daughterinlaw wrote:

Hey everyone! My super sweet 86 year old, quite active, otherwise very healthy, mother in law has just been diagnosed with stage 4 Invasive Ductal Carcinoma.  It has already spread to her spine via a large tumor that needs radiation. She wants to refuse the radiation treatment and do ONLY the hormone therapy. She has a tomato-sized tumor where the left breast used to be.... she told me she's had "something in there" for at least five years and was "too scared" to tell a doctor or any family member about it..... and doesn't want surgery to remove it, either. Now, this woman has every bit of her wits about her. No problem there. Sooooo, how do I handle this? Try to talk her into the radiation? Let it ride? I just don't know anything about this. She says it won't make that much difference in life expectancy at her age. But she's really healthy! Somebody give me something to counter with, please?

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Mar 25, 2009 01:09PM samiam40 wrote:

Wow--that's a tough one.  I just went through the opposite situation with my 80 year old bedridden father who had metastatic lung cancer and insisted on putting himself through chemo to prolong his life a few months.

You sort of have to respect her wishes.  Maybe you could take her to get a 2nd opinion and if she likes or respects the 2nd doctor better, might be willing to follow his advice?  I've found, at least with my elderly relatives, they are very trusting of doctors they "like," so if you find the right one, maybe he/she could persuade her.  Otherwise, you are sort of stuck because they are adults and have the right to choose their own treatment.

I wish you much luck with this.  It is wonderful that you are taking such an active and loving role with your mother in law.  Please keep us posted as to what happens.

Dx 1/12/09 @ age 40, IDC 2.6 cm, Stage 2a, Grade 1, 0/10 nodes, ER+/PR+/HER2-, Onco 14, BRCA neg. Bilat mx w/TEs 2/3/09. CMFx6 3/2-6/15/09. Zometa 5/09-9/10. Tamox 7/09-present Exchange w/gummy bears 9/9/09. N/A recon 12/16/09.
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Mar 25, 2009 01:29PM barbe1958 wrote:

We urged my Dad with his lung cancer to do all he could. It took him 2 1/2 years to die. He said if he knew it would make him feel so sick he wouldn't have done any of it. Quality of life means something....

Dx 12/10/2008, IDC: Papillary, Left, 1cm, Stage IB, 2/5 nodes, ER+/PR+, HER2- Surgery 12/16/2008 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right Dx 2/4/2016, IDC: Papillary, Left, Stage IV, ER+/PR+, HER2- Hormonal Therapy 2/11/2016 Arimidex (anastrozole) Radiation Therapy 2/17/2016 Whole-breast: Lymph nodes, Chest wall
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Mar 25, 2009 02:51PM idaho wrote:

My eighty year old mother chose to do radiation on the tumor on her spine,  they burned her intestines and she died rather quickly,  which was a blessing since she was so sick from the radiation. I wish now she had left it alone, we would have had her here longer, and maybe not so sick?  Tough decision, but it is ultimately hers to make.  Tami

There's no place like home......There's no place like home Dx 2/1/2009, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Mar 25, 2009 03:00PM 1stick wrote:

I have to agree with idaho.  My Grandma had radiotherapy and was terribly ill with it.  She never really recovered and died pretty quickly.  She found the whole process upsetting and completely degrading.

Be there for her and support her all the way.  She's had a great 86 years and is probably right about life expectancy.

Gosh how difficult for you. Take care 

Dx 1/29/2009, 1cm, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Mar 25, 2009 03:05PM awb wrote:

 When they found a grapefuit sized tumor in my grandmother's abdomen, she was very emphatic that she wouldn't have any surgery, rads or chemo.  She was 83 and it was metastatic colon cancer. I understand completely why she didn't want to go thru any chemo or radiation (had other medical issues as well), but sometimes I wish she  had at least  had the tumor removed surgically, as she was in a great deal of pain as it grew larger and compressed other organs. But it was her decision, and we had to respect that.

Anne

"I don't know what the future holds, but I know who holds the future" Dx 9/5/2003, LCIS, Stage 0, 0/0 nodes Surgery 9/16/2003 Lumpectomy: Right Hormonal Therapy 10/30/2003 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 4/5/2005 Prophylactic ovary removal Hormonal Therapy 2/28/2009 Evista (raloxifene)
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Mar 25, 2009 03:06PM simpsojc wrote:

As a Breast Cancer Coordinator R.N., I can tell you that I have seen many large breast tumors that have been left untreated.  Unfortunately, many of them actually ulcerate through the surface tissue of the breast and can become a medical management nightmare.  They "weep" a drainage that can smell horrific and can be prone to infection and bleeding.  Any chance she's ER/PR positive?  Have they thought about trying anti-estrogen therapy if she is?  I've seen large tumors show remarkable regression just from these oral medications.  Obviously it's her body and her choice, but the "tomato" on the breast is just going to get bigger and more unmanageable.

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Mar 25, 2009 03:09PM OneBadBoob wrote:

Difficult decision as to how to proceed/advice.

My 82 year old BIL was diagnosed with jaw cancer and they wanted to do a huge surgery--replacing part of his jaw bone with bone from his leg, chemo, and radiation.

He said are you kidding?  So I can live to 88, miserable, learning to talk and eat and walk again?  Forget it--I have had a great life, and I will continue untill my maker calls me back home.

We were all devistated with his decision, but he was stubborn and we had no influence on him.

So, here we are, five years later, he is 87 and can still talk, eat and walk.  Yes, he has a "lump" on his jaw, but other than that, he is doing fine.  Macular degenertion is his biggest problem at this point.

It taught me a great lesson that we are each totally in charge of our own health care decisions.  Period.

Big hugs to you in supporting your MILin whatever decisions she feels are best for her.

Jane - Dance as if no one is watching!! Dx 7/7/2007, IDC, <1cm, Stage I, Grade 1, 0/2 nodes, ER+/PR+, HER2-
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Mar 25, 2009 04:30PM daughterinlaw wrote:

Wow, thanks for all the great support! Buuuuut...... NOW I have another question, which has been raised from some of y'alls (holy moley - is THAT southern or WHAT?) responses.  The radiation itself: does it usually make people sick - as in vomiting, etc.? By the way, she will not be having chemo. Period. That was a collective decision that was thrown under the bus right from the word go. Anyway, being sick is one of her worst fears. She's not too worried about the pain that she's going to face, because she knows there are some very good pain meds. Her husband died of throat and lung cancer back in 1986. He, too, did not go to the doctor until it was a stage four. By then the tumor on his neck was weeping and he was wearing those kerchief things around his throat to hide it. His excuse for not going was...he didn't want to quit smoking, and he knew the doctor would make him.

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Mar 25, 2009 05:10PM - edited Mar 25, 2009 05:14PM by idaho

The radiation usually does not make people sick, In my Mother's case she was so sick because her intestines had been ruined from the radiation.  Older people just don't tolerate stuff like that very well. Their tissues etc. are so much thinner.  Has she thought about surgery?  Definately let her try the estrogen blockers, that might do the trick... Good luck,  Tami

There's no place like home......There's no place like home Dx 2/1/2009, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Mar 25, 2009 05:47PM Mayer wrote:

I'm on this board to discuss my 69 yo mom's diagnosis and treatment.  Like your gmom, she refused treatment.  Scared us all silly.  But then one surgeon we consulting said it is a common reaction for people her age to have and to leave her alone about except to encourage her to get 2-3 opinions.  By the 3rd opinion, my mom decided to have surgery, no chemo, no radiation.

 Its been tough for me, but i've come to accept she has had a full life and it is her cancer, her breasts, her story.  Maybe it is her intuition telling her it is too far gone.  Who knows.  I'm just trying to love her as much as I can and be greatful ;-) for every day I get.

I hope you find peace in your situation

Dx 3/10/2009, IDC, 4cm, Stage IIIB, Grade 3, mets, ER-/PR-, HER2+
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Mar 25, 2009 09:29PM ICanDoThis wrote:

My 85 year-old mother in law did the same thing! She was determined that this was what she was supposed to die of. We had to respect her wishes, although it devastated my father-in-law (they were married over 50 yrs) and DH.

However, her family doctor talked her into taking tamoxifen (a hormonal), and she was able to enjoy her granddaughter for a year longer than originally estimated.

Good luck - I know how hard this can be

Sue

Sue - Proud to be Krista's Mom Dx 12/28/2007, IDC, Left, 1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH)
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Mar 26, 2009 05:02AM - edited Mar 26, 2009 05:04AM by Brenda_R

At 86, you have to respect her decision.

I can only tell you that while I was in radiation, there were a few older ladies there and all of them had surgery and radiation. No chemo. The doctor didn't think it necessary to put elderly people through chemo. Radiation to the breast area most likely won't make anyone sick. The rads shouldn't go deep enough to affect inner organs. Worst thing from rads is skin burn, some ladies do, some don't. I ran across one lady that had a mastectomy and still had rads. I didn't ask her why. 

---------------------------------------------------------------------------------------------------

Mayer- One important thing- I see your mom is Her2 positive, that means a fast growing tumor. 

She should at least get Herceptin to shut down tumor growth. Herceptin is very do-able, shouldn't make her sick. Maybe a runny nose and mild diarhea at first.

Herceptin is the life saver for us Her2 + ladies.

Dx 12/12/2006, IDC, 3cm, Stage IIIA, Grade 3, 1/17 nodes, ER-/PR-, HER2+ Surgery 12/29/2006 Lumpectomy: Right; Lymph node removal: Right, Underarm/Axillary Chemotherapy 1/28/2007 AC Radiation Therapy 5/1/2007 Breast Targeted Therapy 7/10/2007 Herceptin (trastuzumab)
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May 1, 2017 08:13PM CCtoo wrote:

at 90 she doesn't have estrogen!! Or much left...her cancer is too far gone if spread to her spine...my mother was diagnosed at 89 with tumor bursting out of her breast...she had me she did not want..had some chemo, but then it spread to brain and spine. Nothing helped.

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May 1, 2017 08:13PM CCtoo wrote:

at 90 she doesn't have estrogen!! Or much left...her cancer is too far gone if spread to her spine...my mother was diagnosed at 89 with tumor bursting out of her breast...she had me she did not want..had some chemo, but then it spread to brain and spine. Nothing helped.

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May 1, 2017 08:25PM susan_02143 wrote:

This post is from 2009. Little late to be helpful! I am sorry to hear about your mother.

anotherplan.blogspot.com... and its back. May 3, 2010 mets found. Five years NED on Faslodex * 4/2015 progression to bone * 6/11/2015 Femara/Ibrance * 12/27/2015 Xeloda * 2/24/2016 Xgeva * another progression, another drug Taxol 2/14/2017 Dx 6/8/2005, IDC, 3cm, Stage IIB, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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May 1, 2017 08:31PM Kicks wrote:

This Thread had not been posted (until you posted) in 8 yrs. The OP has not been back to the site in 8 years either.

Dx 8/7/2009, IBC, Stage IIIC, 19/19 nodes, ER+/PR-, HER2- Chemotherapy 8/25/2009 AC Surgery 10/21/2009 Lymph node removal: Right; Mastectomy: Right Chemotherapy 11/11/2009 Taxol (paclitaxel) Radiation Therapy 2/4/2010 Breast, Lymph nodes
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May 1, 2017 08:43PM gracie22 wrote:

My mom passed away last month, roughly a year after being diagnosed with advanced endometrial cancer. She was 82 at diagnosis and generally healthy. She too refused chemo right off the bat, but agreed (very reluctantly) to external beam radiation, about 25 sessions as I recall. Within a month of the end of rads, she began experiencing multiple pelvic bone fractures though she had not had osteoporosis. She also had extreme fatigue and a "not well" feeling that began midway though rads and never resolved. The last 9 months was a horror show of pain management. And as it turned out, we discovered that the cancer had metastasized to her lungs during one of her hospitalizations for the pelvic fractures. That had likely happened before treatment even started, but her surgeon and radiologist had not done a PET, only a CT which they said showed a couple of small non-concerning lung nodules. Had we known about the metastasis (the PET would have given a good inkling), we would have never consented to the radiation which brought her (and us) nothing but intractable pain rather than a decent last year or two with her family. I agree that you should go with her wishes with a caveat: if the tumor is close to breaking through the skin, and she and her docs think she could get through simple mastectomy, agree with simpsojc that you may want to consider surgery in order to avoid having to do wound management of a fungating tumor. And even at her age, the anti-hormonal meds may help with the spinal tumor if she is highly ER/PR positive and cares to try them.

Dx IDC, Right, 4cm, Stage IIA, Grade 3, 0/2 nodes, ER-/PR-, HER2+ (FISH) Surgery Mastectomy: Left, Right; Reconstruction (left); Reconstruction (right): Silicone implant
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May 1, 2017 11:59PM ChiSandy wrote:

Were I 86, I would do the minimum necessary and enjoy the rest of my life. What good is surviving an extra year (or less) if you are sick and in pain the whole time? Most patients that age are rarely prescribed radiation because of its effects on fragile bones & lungs (and if to the left breast, the heart). So many people—especially patients’ loved ones--confuse “doing all we can” with “doing all we should.”

My mom, at 84 and with cor pulmonale (right-sided congestive heart failure from COPD, 20 yrs after quitting decades of heavy smoking) had a CT scan reveal a 6cm lung nodule “highly suspicious for malignancy.” She refused even a biopsy—she’d seen too many of her friends in their 80s & 90s go through surgery & chemo, suffer miserably, and die anyway. She chose home hospice instead. She lived an extra seven months, half a year past her 85th birthday, and was discharged from hospice a month before her sudden death, from a heart attack. Except for the last day of her life, when she had come down with a cold, those seven months were filled with pleasures: friends, family, holidays, restaurants, movies, shopping trips, and her pastimes such as books, TV, crossword puzzles (in ink) and computer games. I shudder to think what might have been had she agreed to a biopsy & cancer treatment.

Diagnosed at 64 on routine annual mammo, no lump. OncotypeDX 16. I cried because I had no shoes...but then again, I won’t get blisters.... Dx 9/9/2015, IDC, Right, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 9/23/2015 Lumpectomy: Right Radiation Therapy 11/2/2015 3DCRT: Breast Hormonal Therapy 12/31/2015 Femara (letrozole)

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