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Old 06-10-2021, 11:15 AM
Status: " What next?" (set 6 days ago)
 
14,094 posts, read 22,849,505 times
Reputation: 25836

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Quote:
Originally Posted by phoebesmom View Post
My dad's cancer doctor pushed treatment past when Dad wanted it, and was angry with Dad for discontinuing. Dad just wanted it over, out of the pain and the progression of the disease. He had to really assert his right to not continue with treatment. It was hard because my brothers did not want him to go to hospice, thought he would be "giving up."

If they had not been there, I would not have advocated that he treat the cancer spread, and just advocate hospice, as he would have had a more peaceful end, and that was all he wanted, to be able to go peacefully.
That’s one of the reasons I really hate people seeing cancer treatment as a “battle”. Too many people are far too literal.
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Old 06-10-2021, 11:34 AM
 
10,893 posts, read 19,619,639 times
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Quote:
Originally Posted by ERH View Post
My mother died from lung cancer that metastasized to her brain. If I were in your shoes, there is absolutely ZERO CHANCE I would put my loved one through any kind of cancer treatment. If the doctors recommend it, then they do not have your husband's best interests at heart.

Death is brutal, but dementia is worse.
My heart goes out to you OP, but I am afraid that I have to agree with this. When my dad had dementia and we were worried about some possible terminal medical issues, my brother and I decided that the kindest thing we could do for dad was to let him pass. He would not have wanted to live like that. At a certain point, it is selfish to keep a person alive.
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Old 06-10-2021, 12:03 PM
 
11,557 posts, read 9,388,876 times
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You may have to do a better job of preparing meat. Loss of teeth and ability to chew the meat is a serious problem for elderly with dementia. You may have to put it into a food processor if smaller and tenderized pieces still pose a problem.

Broken bones will heal in a few months.

There's nothing anyone can really make any informed comment about the cancer since no one knows how aggressive it is and whether any treatment can be put off. He doesn't seem to have any problems related to it. Maybe the decision can be put off and the dementia problems will worsen first. It would seem at first not to be a life-extending decision (5+ yrs) and more about improving quality of life if symptoms start to show. Treatment can cause swallowing problems.

Last edited by lchoro; 06-10-2021 at 12:23 PM..
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Old 06-10-2021, 02:54 PM
 
Location: Southwest Washington State
28,938 posts, read 19,532,565 times
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Quote:
Originally Posted by Aredhel View Post
Does it make sense to aggressively treat a terminal illness (advanced lung cancer) in a patient who is already suffering from another untreatable terminal illness (fronto-temporal dementia)? Not in my book!

Get hospice and palliative care involved as soon as you have a firm diagnosis, and make it clear to the oncologists you prioritize the quality of your husband's final days over the quantity of them. Depending on what type of lung cancer this turns out to be, it might make sense to try treatment with an immunotherapy agent such as Keytruda, as they are better tolerated than conventional chemotherapy agents, but that is a decision that can only be made after a definitive diagnosis and discussion with a good oncologist, as not all types of lung cancer respond well to immunotherapy agents. Pain management will need to be a top priority no matter what treatment (or non-treatment) you eventually decide on.

Keep quality of life front and center, and you'll be doing right by your husband.

And I am very sorry you're having to deal with this now!
This.

Good luck, OP. Trust your judgement on this.
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Old 06-10-2021, 04:06 PM
 
1,899 posts, read 1,768,842 times
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Quote:
Originally Posted by Aredhel View Post
Does it make sense to aggressively treat a terminal illness (advanced lung cancer) in a patient who is already suffering from another untreatable terminal illness (fronto-temporal dementia)? Not in my book!

Get hospice and palliative care involved as soon as you have a firm diagnosis, and make it clear to the oncologists you prioritize the quality of your husband's final days over the quantity of them. Depending on what type of lung cancer this turns out to be, it might make sense to try treatment with an immunotherapy agent such as Keytruda, as they are better tolerated than conventional chemotherapy agents, but that is a decision that can only be made after a definitive diagnosis and discussion with a good oncologist, as not all types of lung cancer respond well to immunotherapy agents. Pain management will need to be a top priority no matter what treatment (or non-treatment) you eventually decide on.

Keep quality of life front and center, and you'll be doing right by your husband.

And I am very sorry you're having to deal with this now!
Well said, Aredhel.

In a nutshell, Quality Over Quantity. I was faced with a similar dilemma with my mom who was dealing with her stroke-induced dementia. A large (eggplant sized) malignant sarcoma was diagnosed on her leg - previously thought to be a lipoma - and even the investigating physician said to me that he wouldn't subject his own mother to the procedures required to treat it. In her case, it would have involved amputating the leg above the knee followed by chemo. She was 87 at the time.

Fortunately she was loopy enough not to be fully cognizant of what was going on. We just let her continue thinking she had a fatty lipoma. She never would have survived the treatment so her last days, while very far from idyllic, at least weren't pain-filled.

I've never regretted taking that path.

Best wishes to you, OP, as you climb yet another mountain.
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Old 06-11-2021, 02:27 AM
 
Location: NJ
17,294 posts, read 25,614,165 times
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Quote:
Originally Posted by movinon View Post
Well said, Aredhel.

In a nutshell, Quality Over Quantity. I was faced with a similar dilemma with my mom who was dealing with her stroke-induced dementia. A large (eggplant sized) malignant sarcoma was diagnosed on her leg - previously thought to be a lipoma - and even the investigating physician said to me that he wouldn't subject his own mother to the procedures required to treat it. In her case, it would have involved amputating the leg above the knee followed by chemo. She was 87 at the time.

Fortunately she was loopy enough not to be fully cognizant of what was going on. We just let her continue thinking she had a fatty lipoma. She never would have survived the treatment so her last days, while very far from idyllic, at least weren't pain-filled.

I've never regretted taking that path.

Best wishes to you, OP, as you climb yet another mountain.

You made the right decision.

My MIL was diagnosed with stage 4 terminal breast cancer at almost 85. She also had it 2 years before, they said no chemo because it would kill her. Now with it in her breast and lungs, they said yes to chemo. They went to 3 doctors who all agreed. I voiced my opinion, told them chemo made no sense, especially when 2 years earlier they said it would kill her. I said quality over quantity, they didn't listen, did chemo. It landed her in the ER the next day, then straight to hospice where she was bed bound almost 3 months waiting to die.

My opinion from the start after everything I read was that with people living longer, they needed more elderly cancer patients to get treatment statistics, so in my opinion, they used her as a test rat.

The breast cancer she had was a triple negative that someone young and healthy at 35 had single digit odds to live, it's that deadly and resistant to drugs.

The OP needs to be sure they're not going to use her husband as a test rat like my MIL.

I didn't give my opinion in my last post because the OP doesn't have any information to make the decision whether to treat or not treat.

With my family, none of us would want treatment for any illness if we had dementia. We would have a DNR in place. My hub has done 5 wishes, I have not filled one out yet but will be.
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Old 06-11-2021, 08:50 AM
 
Location: Southern MN
8,763 posts, read 5,114,620 times
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Mom was 86, recovering from a broken hip and in a care center when she got her diagnosis of bladder cancer. She was very firm with the doctor that she didn't want the chemo or surgery and the rest of the family was in accord with her. I think it's a bizarre suggestion considering the circumstances.

She did have some cognitive problems but was still lucid enough to recognize that it wasn't a good choice for her. The doctor became so insistent that twice he called my home implying that she was going to die and it was up to me to convince her to have the surgery. I was so distraught by his refusal to accept our mutual decision that I was on the verge of getting a restraining order.

I'd known this doctor for thirty years and his demeanor was markedly different from the gentle, caring doctor I had known. He was angry, blaming, impatient. I often wonder if he wasn't going through some kind of personal crisis which was affecting his work.

It's important for us as advocates to arm ourselves with as much prognosis information as we are capable of gathering. But beyond that we do need to be considerate of our loved ones' wishes as well.

My main focus was preventing prolonged suffering and I think Mom chose well.

It's a difficult situation. I hope you have others who can support you while you support your family member.
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Old 06-11-2021, 10:37 AM
 
11,557 posts, read 9,388,876 times
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They probably recommended it because bladder cancer has a very high long-term survival rate. I know someone who's already had 5 cancer treatments and surgeries at the age of 80. He is absolutely normal, just had 2 cataracts surgeries, and going in for anterior hip replacement surgery. They just moved into an assisted living facility. His wife has early-onset Parkinson's which is now over 10 years. They needed to get away from the 3-level home to avoid her falling in the future and because she does all of the work in and around the house.

The original post mentioned going into independent living facility for her and memory care for the husband. At some point, the ability to take care of someone is too much.
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Old 06-11-2021, 10:42 AM
 
Location: Alabama, West Coast born and raised
1,133 posts, read 1,591,696 times
Reputation: 1300
If I ever become terminally ill I will not fight it. I will not do debilitating chemo treatments or surgery or try to keep myself alive. I will pray for a good death and let nature take its course. My own personal belief is that when we become terminally ill, it's time to go. It's God calling us. YMMV.

I'm so sorry you're going through this, OP. And others here who have as well.


PS If I were ever a health care directive I would follow the person's wishes because it is required by law, and it is respecting their wishes. I wonder if you know his wishes??
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Old 06-11-2021, 01:36 PM
 
10,483 posts, read 5,176,407 times
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Wait til the results come in.

Speculation is unhealthy.

confer with the medical team.

All is not lost simply because his memory is fading.
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