Stage six and possible breast cancer.

ghphotog

My DW's mammogram showed some anomalies in one of her breasts so now we are called in for more extensive imaging. Probably just a false alarm but my question. . . If it is breast cancer and she's in stage 6 somewhere and I have know idea how long she will be in 6 much less 7. I'm wondering if I should have it treated or just leave it alone. She is young and in good health otherwise.

Personal choice I know and I would discuss all of this with her family but I don't know how long any Alz stage will last or how fast breast cancer can spread Would it be worth putting her through the treatment as she is very fragile when it comes to discomfort.

Both timelines are probably unpredictable at best but what are your thoughts?

loveskitties

So sorry you have this additional worry about your DW's health.

If you get a confirmation that it is cancer, I would contact the dr. who is managing her dementia to discuss. Surgery for a dementia patient sometimes causes a downward spiral which can be temporary or lasting.

It will be a hard decision to make, and I wish you and her the best possible outcome.

Quilting brings calm

It’s a personal decision - but I’d ask the cancer doctor what the treatment would entail, what the life expectancy change would be by treating ( if her life expectancy with dementia is x, what would not treating it shorten life expectancy by… and what the quality of life difference would be treating vs not treating. Also whether she could deal with the treatment.

mommyandme (m&m)

I’m so sorry for this additional challenge to this already disheartening journey, it’s so cruel.

mrahope

So, so hard to make decisions like this. But I think you are doing the right thing in thinking of it before any diagnosis of cancer is made. I surely hope it does not turn out to be that.

I've wondered often about these types of issues as my DH is a 3 time cancer survivor. He has been documented to have a genetic predisposition to colon cancer. He is 3 years post-surgery for that. He's refused repeatedly to do follow-ups for this illness. I sometimes wonder if I should have forced him to do this. The calculus (morally) is complex. He has one terminal illness with indefinite prognosis (dementia) and risking another with a more definite prognosis (cancer) might not be so bad... Which suffering is worse?

Not being a philosopher, these decisions are so difficult.

Ed1937

I wouldn't make any recommendations for you, but I will say that my wife had breast cancer twice. She had a lumpectomy the first time, and lost one breast the second time. Both times she refused chemo, and that was pre-dementia. She was a registered nurse, who worked with a lot of cancer patients. I'm not saying your wife should not get chemo treatments or surgery, but they can be hard on the patients. It's very personal.

harshedbuzz

I wouldn't borrow trouble just yet. Is this is a first 3D mammogram? The transition to this more powerful tool has led to many women being called back for more imaging because "new" findings that were probably always there.

Given that dementia is terminal and she's already in stage 6, I personally would not treat. My friend's mom elected to stop mammography at 80 and said she would not treat it if diagnosed. She did develop breast cancer in stage 5-ish at the age of 91. My friend honored her mom's wishes and brought in hospice about a year later. The dementia and the cancer both progressed alongside each other. She died in late stage 6 with hospice support keeping her comfortable.

HB

upstateAnn

if I were the one to decide, I would not treat the cancer. My husband has had cancer three times so I know the routine. With his dementia, I would let nature take its course. Every decision is unique.

​NorthWoods

First, please know how very sorry I am that you find yourself in this struggle. For me these are some of the hardest decisions I’ve had to make as I navigate my husband’s care. I would encourage you, and all caregivers, to have a long honest and difficult conversation with your most trusted health care provider. In my case it was my pcp. She helped me to understand so much about, well, so much. The balance between life expectancy and quality of life is a very difficult one. Guilt, grief, personal ethics, family dynamics, and so much more can make it overwhelming. So talk to your most trusted advisors, think about not just what you would want but what she would want and then move gently forward. Don’t let yourself or anyone else challenge your loving decisions or make make you feel quilt.

I hope you are looking at a false positive. It’s terrifying to face but get help from those that can best guide you. It will still be extremely difficult but you will find your path. She’s lucky to have you

Pat6177

First, I’ve been called back for additional imaging for ea of the last 3 years and there’s been no cancer each time. The new mammograms they are doing are just so sensitive. It’s a real pain cuz it takes a couple of weeks to get the appt and even though I know the chances are slim, I still worry.

I’m lucky because my husband regularly says he is ready and that he wouldn’t treat anything. A couple of comments. I agree with NorthWood’s suggestion to talk it over with a trusted health care provider. Make sure that person has an understanding of dementia. So many people in healthcare really don’t know anything about dementia. In addition to the questions other posters have suggested, ask what palliative care would look like.

You also have the option to stop now and not take her for any more imaging. Not do any treatment at all. That choice is absolutely ok in these circumstances.

M1

ghphotog, I'm with upstate Ann on this one and would not treat any cancer if found except with pain management. I face this with my partner as well, who has an incurable lymphoma.

Assuming that this turns out to be a false alarm, I would also say that i would not do any more cancer screening like mammograms. To what end? Screening recommendations are for otherwise healthy individuals.

FTR--and i don't mean this as harsh as it sounds--when you say your wife is otherwise young and healthy, that's wishful thinking. she has an advanced, incurable disease. Someone else said something similar on another thread just this weekend. PWD are not "otherwise healthy."

Rocky2

Let me also say how sorry I am that you are having to deal with this. My DW, who is early stage 6 EOAD, was recently diagnosed with cervical cancer. We had already made the decission to opt out of all routine cancer screenings. However, the cervical cancer symptoms presented themselves. We did have an exam ans biopsy done which confirmed the cancer. Due to DWs advanced EOAD, we chose to only pursue palliative care/treatment with no aim toward cure.

I agree with much of the feedback given above. Every situation is unique and we are all trying to do our best for our loved ones. I wish you peace of mind and a settled spirit as you move through this process.

Tom

MN Chickadee

I'm sorry you are going through this. I get what you mean about otherwise young and healthy. My mother was the epitome of healthy. She took the best care of her body a person possibly can and apart from her decaying mind it seemed like she could live for decades; at the end of stage 5 she had no bad joints she moved great, was a healthy weight, good blood pressure and vitals, very spry. However there comes a point where the dementia catches up with the rest of the body. Looking and acting young and healthy won't last. I would be wary of cancer treatments compounding the Alz symptoms and compromising her quality of life. I personally would not treat someone in stage 6 dementia for cancer because they will still have this other terminal and incurable disease, and the closer you get to stage 7 the less quality of life is there to preserve. I would instead focus on making her days as nice and comfortable as possible. Does your wife have a living will? Does it give any insight as to what she may want? I hope it's a false alarm but if not wishing you strength as you navigate this.

ghphotog

We don't have a living will but I know she is afraid of dying and I'm fairly certain. . .you know I just don't know what she would want me to do in this situation. Probably a false alarm as she does have breast fibroids or something like that, I don't remember.

toolbeltexpert

ghphotog I am sorry to hear this as it brings those burdens on the caregiver. We all know that you will do what is best and support you, because only you know. My prayers continue for all my forum family.

Stewart

JJ401

“We don't have a living will but I know she is afraid of dying and I'm fairly certain. . .you know I just don't know what she would want me to do in this situation.”

Even a living will may not have answered your question. Most times we make a living will when we are in good health, but it’s not needed until we aren’t. By the time it’s needed our opinions may have been changed by the reality of our situation. I personally think that all we can do is make what we believe is the best choice for our loved one based upon the current diagnoses.