Dementia and cancer

ngreen · July 22

I need major advice.
My mom has dementia and was just diagnosed with stage 1 lung cancer. Very treatable, if not curable. All she has to do is go through some radiation. She is probably in stage 5 or 6 with dementia... very very paranoid about everything and anything medical all but traumatizes her.

She is also a recent amputee (below the knee) and is now wheelchair bound. This is a woman who never sat down for more than 5 mins her entire life, so its a huge change. She isn't very happy. She is in a memory care facility. While its a great facility, she doesnt really participate in anything, but just sits there all day.

My question- would you go through the radiation? Or just let nature take its course? I am very torn. Part of me feels like if we do the radiation than its just prolonging her miserable life. But its so treatable that it would be stupid not to try. What do I do?

H1235 · July 22

I would ask how treatment may affect her dementia. Maybe even do a bit of research yourself. My dad didn’t have dementia, but radiation was not simple at all! I assume there is no living will. My mom chose no to cancer treatments in her living will when she was early stage 4. I would not want to put my loved one through radiation only to prolong their suffering. There is a discussion under caring for a spouse titled tests and medications you might find interesting. Just getting her to and from the hospital, sitting in the waiting room, the drive there and back, her wondering when is the next appointment. It’s just a lot of disruption from her normal routine. I think that alone might cause increased confusion.

Quilting brings calm · July 22

Do you think she will be able to stay still during the radiation treatments? To tolerate them for however many sessions it will take? That needs to be considered. I suppose you could attempt it. My guess is that she won’t be able to deal with it, but you will have tried.

SDianeL · July 23

As HB said, I would search for and read the post titled “TESTS and MEDICATIONS” where many here discussed this very difficult subject. My sister has dementia and breast cancer & her family said no to any treatment. I agree with their decision. Why prolong her life with dementia? My DH passed last August from Alzheimer’s and I made the difficult decision not to have them treat aspiration pneumonia. I have been through breast cancer radiation and it’s very stressful and uncomfortable. I can’t imagine how someone with stage 6 dementia could tolerate it. I would discuss it with the Neurologist and the Oncologist and Radiation Oncologist. I understand how difficult this is for you. 💜

harshedbuzz · July 23

@ngreen

Hi and welcome. I am so sorry for your reason to be here, but pleased you found this place.

You have been presented with a difficult choice.

Given what you have shared about your mom's stage of dementia, her distrust of medical intervention, the potential side effects and what radiation entails, I would be inclined to bring in hospice services rather than treat.

Did you get a chance to talk with someone about what your mom's radiation treatment would look like and what sort of risks/side effects she might expect? Radiation is not a benign procedure. I have a young friend who recently underwent radiation for metastatic breast cancer. She tolerated the Cyber-knife targeted to her brain fairly well but the radiation to her chest required multiple sessions and resulted in terrible burns that have required wound care nursing visits. It's been awful for her.

This is a non-specific overview of radiation for lung cancer.

https://www.verywellhealth.com/lung-cancer-radiation-success-rate-5209320#toc-side-effects

A dear friend's mom developed breast cancer in her 90s. Her mom had opted out of mammography at 80 saying she would not treat if diagnosed, so friend knew how non-dementia mom felt. She honored her wishes and did not treat although she did bring in hospice once pain management might be needed. It was a loving choice.

HB

PlentyQuiet · July 23

I can only answer as if I was in your position, this is my opinion only and not to be taken as a judgement on whatever you decide

I, as well as others here, have been wishing for an off-ramp for our LOs with dementia. The end stages are brutal and I would rather an earlier departure than to slog it out through the very last stages which can involve skin breakdown, bedsores, painful contracted muscles etc.

If she is not participating in MC events and isn't very happy the quality of life is not what I would want for my LO. We are joy focused.

The cancer may not be an aggressive variety, but the chance for hospice and an easier, more straight line path towards peace is one I would advocate for.

psg712 · July 23

Without dementia and with an active, otherwise healthy lifestyle, treatment for stage 1 lung cancer would be a reasonable choice. With dementia...a really tough choice. Chest radiation requires her to climb onto a table, remove garments, lie flat and still, alone in a room with a large machine above her, take deep breaths and hold when instructed, allow technicians to reposition as necessary, ...and repeat this routine daily for the number of treatments prescribed. Can your mom do all of this? Would she have any understanding of why she is doing it?

As a nurse in cancer care, it would be a struggle for me to refuse treatment for my mom for a stage 1, potentially curable cancer. But I know that she already has a terminal illness- Alzheimers - and that while she was cognizant, she stated that she would not do cancer treatment again (she's a long time survivor of breast cancer). I would have to honor her wishes.

I feel your dilemma. God bless you as you do the best you can for your mom's comfort.

Dementia and cancer

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