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Having recently been treated for BC and going through it w/ my mom now. I would suggest getting alot more info before surgery and making a treatment decision. What stage is she in? What type of BC is it? How agreesive a form is it? What type of surgery are they recommending? (Some lumpectomies can be pretty minimal depending on the location) What about other treatment? If it is a slow growing form in the very early stages, how long would it take to spread and threaten her life? Will she live that long anyway? Likewise, if she is in the later stages just what would be the survival benefit of undergoing surgery? Just things to think about.
My 93 yo g-mother has had a lump on her breast the size of a robin's egg for almost a year now and doesn't plan to have anything done. Her doc was furious with her for not having it looked at but she looked him in the eye and reminded him that it's her body. I'm quite sure she's making the right decision and support her, b/c I can't imagine that anything good would come with surgery at her age.
My 93 yo g-mother has had a lump on her breast the size of a robin's egg for almost a year now and doesn't plan to have anything done. Her doc was furious with her for not having it looked at but she looked him in the eye and reminded him that it's her body. I'm quite sure she's making the right decision and support her, b/c I can't imagine that anything good would come with surgery at her age.
Same with my mother! At 93, a good size lump on her breast. She wanted to have it out, it was her decision, and she was of sound mind. I was very skeptical. She did fine, and surgery also included taking some lymph nodes. On her follow up appointment, she dug her heals in, refused any prescriptions, or mention of a re-check. She said "thanks" and said she wouldn't be back. She passed at almost 97 years old, in her sleep, a happy woman.
No, not really. My mother will not be swayed. Apparently she is the driving force behind the surgery for my grandmother. She will not seek a second opinion and won't discuss the situation at all.
Surgery is this coming week. I'm just crossing my fingers that she does well. I do not know if radiation or chemo will follow. I assume so. Because of the concerns I've expressed, I'm been pushed out of the loop.
No, not really. My mother will not be swayed. Apparently she is the driving force behind the surgery for my grandmother. She will not seek a second opinion and won't discuss the situation at all.
Surgery is this coming week. I'm just crossing my fingers that she does well. I do not know if radiation or chemo will follow. I assume so. Because of the concerns I've expressed, I'm been pushed out of the loop.
Thanks for asking
I guess you haven't spoken to your grandmother?
I would google map the place/doctor & write a review if they do her surgery.
How is your grandmother's general health? Does she have diabetes? Heart disease?
How much does she weigh? At her age, probably skinny! That implies to me that she may have small breasts --- more about that later.
How do we know she has cancer? Has a biopsy been done, mammogram, or just a lump found by the patient or her doctor?
If the diagnosis has been confirmed, what surgery is planned? Lumpectomy? Mastectomy? This is where the size of the breast comes in: a lumpectomy in a small breast can be the equivalent of a mastectomy!
If the diagnosis has been confirmed, is there any evidence that the cancer has spread to other organs or lymph nodes?
As far as the Coumadin is concerned, it can be reversed with Vitamin K shortly before the surgery, and other anticoagulants used immediately afterward. A lengthy period off of blood thinners is not necessary. If what we are talking about is just a lumpectomy in a small breast, conceivably it could be done without stopping the Coumadin, though the surgeon would have to be very meticulous about controlling small bleeders, there would be more bruising, and a greater risk of developing a hematoma --- a blood clot --- in the incision itself. That would increase the risk of infection.
She should not be confined to bed after the procedure --- that just invites phlebitis --- blood clots in the veins of the legs.
As far as anesthesia is concerned, if the procedure is to be a lumpectomy, is it possible to do it with a local anesthetic and sedation? That would decrease the risk from the anesthetic itself and the risk for post-operative pneumonia.
Even if all that is done is to remove the primary cancer in the breast, there is value in doing it to improve quality of life. Her life expectancy (average) at age 93 is about 4 years. If the cancer is aggressive and already large, it can grow through the skin, ulcerate, smell very bad, and be extremely difficult to deal with. There is more to consider than just pain relief ---though that is important, too.
More and more people are living to their nineties, and surgeons are offering them procedures that would have been unthinkable in the not too distant past. They do remarkably well!
Finally, someone needs to coordinate her care and be on top of any other medical conditions, so nothing falls through the gaps. If she is in a relatively large hospital, there may be a "Hospitalist" to do this --- an internal medicine specialist who only takes care of people in the hospital, with someone available around the clock. Otherwise, make sure her internist or family medicine doctor knows what is going on.
I am very sorry that your grandmother is in this position, and I regret that your concerns are not being taken seriously by your mother.
Last edited by suzy_q2010; 06-19-2010 at 12:19 PM..
Reason: Correct typo
No, not really. My mother will not be swayed. Apparently she is the driving force behind the surgery for my grandmother. She will not seek a second opinion and won't discuss the situation at all.
Surgery is this coming week. I'm just crossing my fingers that she does well. I do not know if radiation or chemo will follow. I assume so. Because of the concerns I've expressed, I'm been pushed out of the loop.
Thanks for asking
That's too bad Maggi. I'll keep you all in my prayers. Hopefully everything will be ok.
She's not super healthy. She is very prone to pneumonia, has a pacemaker, and has had several TIA'a and one larger stroke years ago. No diabetes.
Yes, she is very thin and has small breasts. The surgery scheduled is a complete mastectomy. At least one biopsy was done. They do not know if the cancer has spread or not. She will be spending about 3 days in the hospital, if all goes well.
She's already been off the Coumadin for a few days. I doubt anyone would be open to the vit K suggestion, although that is good to know.
I spoke to her today and asked her if she was going to consent to radiation or chemo. She said she would just wait and see what the doctor said. I reminded her that she has the right to say no to anything she doesn't want to do. It was obvious she hadn't even considered that. I reminded her to get up and move around as soon as possible. She agreed, so that's good.
Honestly, she's just not the kind of lady who has much practice standing up for herself. And my mother is dead set on going all out on this. My mom is scared of losing her mother. I know that. I know how hard it is to let people go. But it's sad that we (as a society) have lost the ability to respect the natural process of death. All the surgery and medication in the world isn't going to keep anyone alive forever (thank goodness!). My mom thinks this will save her mom.
She's not super healthy. She is very prone to pneumonia, has a pacemaker, and has had several TIA'a and one larger stroke years ago. No diabetes.
Yes, she is very thin and has small breasts. The surgery scheduled is a complete mastectomy. At least one biopsy was done. They do not know if the cancer has spread or not. She will be spending about 3 days in the hospital, if all goes well.
She's already been off the Coumadin for a few days. I doubt anyone would be open to the vit K suggestion, although that is good to know.
I spoke to her today and asked her if she was going to consent to radiation or chemo. She said she would just wait and see what the doctor said. I reminded her that she has the right to say no to anything she doesn't want to do. It was obvious she hadn't even considered that. I reminded her to get up and move around as soon as possible. She agreed, so that's good.
Honestly, she's just not the kind of lady who has much practice standing up for herself. And my mother is dead set on going all out on this. My mom is scared of losing her mother. I know that. I know how hard it is to let people go. But it's sad that we (as a society) have lost the ability to respect the natural process of death. All the surgery and medication in the world isn't going to keep anyone alive forever (thank goodness!). My mom thinks this will save her mom.
Thank you all for your thoughts and suggestions.
I'm sorry.. I really am.. nothing I can say to you will ease any of the pain you're feeling. Reading this post.. I have tears in my eyes.. WTF gives a lady her age a mastectomy?
I just went on wiki - types -
*Simple mastectomy (or "total mastectomy"): In this procedure, the entire breast tissue is removed, but axillary contents are undisturbed. Sometimes the "sentinel lymph node"--that is, the first axillary lymph node that the metastasizing cancer cells would be expected to drain into—is removed. This surgery is sometimes done bilaterally (on both breasts) on patients who wish to undergo mastectomy as a cancer-preventative measure. Patients who undergo simple mastectomy can usually leave the hospital after a brief stay. Frequently, a drainage tube is inserted during surgery in their chest and attached to a small suction device to remove subcutaneous fluid. These are usually removed several days after surgery as drainage decrease to less than 20-30 ml per day.
* Modified radical mastectomy: The entire breast tissue is removed along with the axillary contents (fatty tissue and lymph nodes). In contrast to a radical mastectomy, the pectoral muscles are spared.
* Radical mastectomy (or "Halsted mastectomy"): First performed in 1882, this procedure involves removing the entire breast, the axillary lymph nodes, and the pectoralis major and minor muscles behind the breast. This procedure is more disfiguring than a modified radical mastectomy and provides no survival benefit for most tumors.
*Skin-sparing mastectomy: In this surgery, the breast tissue is removed through a conservative incision made around the areola (the dark part surrounding the nipple).
*Nipple-sparing/subcutaneous mastectomy: Breast tissue is removed, but the nipple-areola complex is preserved.
I don't know if showing her photos would help.. I found these - it shows the scars.
I wish I could find a study on elderly BC patients. I'll keep looking later on.
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She will not seek a second opinion and won't discuss the situation at all.
Your grandmother
