get cancer check-up?

l7pla1w2 · August 22

My question is related to the recent one about a GYN appointment.

DW had a thymectomy in 2021. She did not need follow-up radiation or chemo. She has had semi-annual check-ups since then and is now on an annual check-up schedule. So far all of them have been clear Her next one would be in October. It entails a blood draw, followed later by a CT scan.

DW is in MC and has not left the facility since she moved there in April, so the check-up would be the first time for her to leave. The facility's nurse can do the blood draw; the CT scan would be off-premise.

Apart from her diseased brain, DW is otherwise pretty healthy. Based on the comments in the GYN appointment discussion, I suppose I should be asking the doctor and myself, what happens if they find something?

Comments?

Chance Rider · August 23

Such difficult decisions to be made. I have no advice, we’re brand new to this journey. I think when I’m faced with such decisions I’ll weigh quality of life vs quantity. Best to you.

Anna2022 · August 23

I'm thinking of the question I learned here: "what will you do with the information the test gives?" If cancer is detected, will you proceed to treat that or let it go considering her circumstances in MC. If you would not subject her to cancer treatment, then the test is not necessary.

Quilting brings calm · August 23

What can the blood draw itself tell you? Does it indicate a level of some medication she takes ( or sone other blood level) due to not having a thymus? If so, then treating that might fall under comfort care if an inappropriate level could cause her issues. I’d suggest keeping the blood draw, but discussing her current cognitive and MC status with the doctor/nurse through a portal text or a phone call. If you wouldn’t have a cancer diagnosis treated ( for whatever reason), then I’d ask if the CT scan could be skipped.

Quilting brings calm · August 23

Since I still cannot edit my comments, I am adding another comment to ask this:. Would your wife be able to handle chemo or radiation treatments? If not, then there is your answer.

SDianeL · August 23

when I joined this group I remember the advice that if you have difficult decisions to make to “play the scenario all the way out” which is the same as what would you do with the info. The blood draw is usually to check kidney function before a CT Scan with contrast. I just had one. So if no CT no need for blood draw. So let’s say the scan shows something. Would you put your loved one through cancer treatment knowing they have dementia and probably wouldn’t understand what was going on and have increased anxiety because of the testing and treatment? They already have a progressive terminal illness. My decision would be no to the test and no to treatment. I would only do things that made them comfortable.

trottingalong · August 23

my husband has advancing COPD. No more unnecessary doctor appts. He is terminal, so why put him through more tests.

l7pla1w2 · August 23

https://alzconnected.org/discussion/comment/251347#Comment_251347

The blood draw serves two purposes. The first is, as you suggest, to check kidney function to determine whether it's possible to use contrast in the CT scan. The second is to look for cancer markers in her blood.

I've been mulling the quality of life question. I guess the unknowable is, if the cancer recurred, how would that affect DW's life if it were untreated? I think there's a big "it depends" there. How aggressive is the recurring cancer? The original thymoma was discovered by accident and turned out to be pretty big, although it did not manifest any obvious symptoms.

I think a consultation with the oncologist is in order, so I can ask the "what if?" question(s).

Thanks for your comments.

Carl46 · August 23

The thing about cancer is, there is effective treatment for pain and hospice will administer it because no one cares if a terminal cancer patient becomes addicted to morphine. There is no effective treatment for the fear and confusion of Alzheimer's. I chose not to treat my wife's lymphoma because I regarded it as God's blessing, shortening the misery she had experienced for eight years. Chemotherapy would have made her very uncomfortable, she would not have understood why she was uncomfortable, and the treatment would not have significantly extended her life.

Euthanasia is a sin and a crime. However, accepting relief when God offers it is neither. In your shoes, I would not permit the testing.

l7pla1w2 · September 5

I have a belated follow-up. I asked someone whose opinion I value and who has experience with PWD. She agreed that I should skip the tests, that DW is in a good place, physical and mental, and it would be a mistake to upset that.

Then I checked with the oncologist and challenged her about the wisdom of treatment if tests revealed something. She seemed more in the doctor's mentality of, "We have to do something." But she did agree that DW's checkups have so far been good, and we could skip tests for now. She didn't address the wisdom of "do[ing] something" at all.

get cancer check-up?

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