Just last week a reader asked me whether she should try to sway her mother, who had colon cancer, toward surgery. Her mother, 87, was diagnosed with colon cancer and given the choice of surgery and chemotherapy or letting it alone. If she chose not to have surgery, she could still have chemotherapy and radiation, though she was told that treatment wasn't apt to help a great deal. As expected, the daughter was distraught. She was seeking help in determining what her responsibility to her mother is.
The woman mentioned that her mother was mentally sharp, so I told her that, in my opinion, her mother should be given all available information and then left to make her own decision. Barring advanced dementia or other mental issues, I feel elders should have the right to make informed decisions about their own health.
When sharing my personal opinion with this woman, I made it very clear that an informed decision includes information on what anesthetics can do to the aging body. Several studies have been done on the effects of anesthetics on the aging body; however the one I often go back to was done by researcher Roderic Eckenhoff, of the University of Pennsylvania in Philadelphia. Eckenhoff was especially suspicious of one commonly used anesthetic, isoflurane, as a possible culprit in pushing some elders over the edge into dementia.
This is a subject close to my heart, as my dad had surgery to relieve pressure from fluid on the brain due to an old World War II injury. A shunt was put into dad's brain to drain excess fluid. This type of surgery is not uncommon and is generally successful. Dad went into surgery a little fuzzy from the fluid, but still very much himself. A day after the surgery, he fell into a hellish dementia from which he never recovered until death took him a decade later.
I've heard from a number of caregivers who wonder why their parent, who went into the hospital for a fairly simple surgery, came home and never recovered his or her mental capacity. The agonizing question from these people is simply, "What happened? She was mentally clear and this operation could have been avoided."