Cancer at age 90. Any advice?

My father is 94 and fortunately is in excellent health. At his point in his life all he wants to do is enjoy whatever time he has left without any poking and prodding from Drs. and I agree with him 100%. There is absolutely no way I would even consider chemo and or radiation on a LO at that age. They have lived a long life and to put them through, heaven knows what kind of treatment plan, just doesn't seem right to me. My father has had an aneurism in his leg for quite a few years and to interfere by doing surgery could possibly cost him his life so we've decided to leave well enough alone and let nature take its course.

Lizzy, the OP is long gone, they haven't posted anything except this one question back in June - in any case I wasn't addressing them but trying to point out that this is an old question that has already been well answered.

This question was asked back in June and had 40 replies at that time - I'm not sure why it has come up again...

At 80, I told my DH he didn't have to do the Chemo but he said he did. He lived another 16 years.

We had a scare a few years back and again he felt he should but I wouldn't have put him through that.

Talk it over with your father - Chemo is very hard on the body, and it is not guaranteed.
I would refuse treatment at that age - in fact, I'm only 66 and I'm not sure I would do it now either. As I said, it's very hard on the body and not guaranteed. The body is bombarded with heavy metals that never leave the system.

It is a good time to make sure everything is in order for the inevitable.

I am 81 and if I get cancer, I will want only palliative care. This is what my mother (liver cancer) and my cousin (colon cancer) chose. They got morphine and palliative care, and lived only a few months (or weeks in my mother's case) after diagnosis. Dementia runs in my family, and I fully believe it is better to die after a brief illness than to live for years with dementia. I was a cancer researcher for most of my career (but worked in the lab and peer review, not with patients).

From my point of view, there is cancer at 90 and then there is cancer at 90 with dementia, lack of understanding of what is happening and the desire (on the part of the elder) to just be comfortable.

This was the case with my mom at 89; she had been dxed with MCI and, because of fluid build up around her lungs, had fluid drawn off. Some "atypical" cells were appreciated. The oncologist wanted to do a bone marrow biopsy.

A. Mom said "no bone marrow biopsy"
B. She wouldn't have done whatever treatment was going to be recommended. She was DONE with being "treated".

A wise geriatrician told me at the time: "if the patient is going to refuse the treatment, then DON'T do the test".

Words to live by.

My Dad is 89 and was recently diagnosed with cancer. Since he is in relatively good health he and his doctor decided to proceed with radiation treatments. He had his 10th out of 44 treatments today and is handling it well.

Robert, I don’t know what country you are from, since you say “That’s why YOU PEOPLE lose a lot of YOUR elderly parents early in THIS COUNTRY.” I assume you think everyone here lives in the United States?? I do believe this site reaches other countries… But, to set the record straight, the United States has more centenarians than any other country. So, I think that is an indication that we do take care of our elderly.

Deciding whether or not to treat an elderly parent/loved one who was diagnosed with cancer is a hard decision for anyone. Feeling that people should treat cancer no matter what the age, just because we can, is too simplistic. It would certainly depend on whether or not there are underlying conditions that would result in complications, what the prognosis is -- with and without treatment, and if the wishes of the loved one is known. People do have the right to decide how they want to be treated, if they are competent. The doctors would certainly talk to the family and tell them what to expect, so that they can make an informed decision.

Yes, you have heard of successes. Great. It is also great that the person you know had very few medical issues, outside of the cancer. That is probably why she was treated. Not everyone is like that.

My brother, who is 71, has pulmonary fibrosis, and was recently diagnosed with leukemia. He is taking a chemotherapy drug that has a good success rate. The pulmonary fibrosis, though, will probably take him before his treatment is finished. But, for him, it is worth the effort.

My Mom is 94. Twenty years ago, she said that if she had cancer, she would not want to treat it, even at that age. I, personally, would not have liked that, but she knew what she wanted. She was a nurse; plus she saw her mother die of cancer at age 63.

Hey, I would love for my Mom to live forever. That is just not realistic, and probably selfish on my part. She was always active, even doing yard work when she was 92. She has had a heart attack and a stroke. Now, she has expressive aphasia, where 99% of what she says in nonsensical. She can no longer write her name. She can no longer do what she liked to do – even clean her house and make her own meals. She needs assistance walking, and with all personal care.

So, what do you think we should do if she happens to be diagnosed with cancer? Do we honor her wishes, or do we treat it? Do you think her quality of life would improve if she went through surgery or chemotherapy? Do you think she would even survive the treatments with her underlying medical issues? Is it worth the risk?

There's cancer, and then there's cancer. There is stage 0 and stage 4. There are cancers that can be cured with extensive surgery and no follow on radiation or chemo and there is cancer that has a 90 percent chance of killing you in a year no matter what you do.

There are 90 year olds who are running marathons and teaching graduate school. And there are 90 year olds with dementia who are abed, anxious and not eating or drinking.

"It depends" sounds facile and dismissive, but in this case, it's true. No one is trying to write an elder off, Robert, we're just seeking to understand what the OP's question REALLY is.

It sounds as though she is looking for symptomatic relief for her parent. An obstructed bowel is a horrific way to die, so I'm told. So I would opt for surgery in that situation, even if it might mean death in the midst of the operation.

We are here to support, not to condemn.

I agree with Rosses, Robert -- we come here for support and helpful advice, not to be insulted as you have done. Your comments were very hurtful. We are all trying our best to care for our loved ones. The lives of every one of us are incredibly difficult and we need only constructive feedback. We'd be very grateful if you would try to help us rather than insulting those of us who are trying so hard to care.

Robert,

“Very heartless”.. “people who apparently are very pessimistic about life in general” and “do not respect their elders”..
I kindly suggest you re-read all the answers. They are all full of love..and in many cases coming from experience.  All caregiving paths are very tough and no one should be judged for literally wanting the best, understanding the best is a subjective term.

Although you’re entitled to having an opinion, on this website people should not insult, generalize or judge and you are doing all three. I don’t believe that helps or enlightens anybody.

I’m providing some well intended constructive criticism because I feel you might need to think twice next time you answer a question in those terms.

A lot of these answers to the question above are very heartless, coming from people who apparently are very pessimistic about life in general and do not respect their elders. Thats why you people lose a lot of your elderly parents early in this country because you do not give peanuts about them.

Listen to this, someone I know was recently ( January 2018 ) diagnosed with a tumor in the sigmoid colon of the large intestine. This came from a colonoscopy on a biopsy. The person had been suffering from strong stomach pains, bloody stools, diarrhea and constipation for the past few months. The person was diagnosed further in November 2017 with diverticulosis and diverticulitis, a bacterial infection close to or in the same sigmoid colon area where the tumor was blocking the lumen of the intestine for a while. A CT Scan of the abdomen from November 2017 showed an enlarged lymph node in the area which the doctors comment was due to the bacterial infection of the diverticulitis. The biopsy of her tumor in January 2018 showed malignant cells, This tumor was a cancer. The patient was healthy otherwise. She was not suffering from anything else in her body except for some mild diabetes and arthritis. CT Scans and MRIs were done of her body and nothing showed up. The patient was clear for surgery which was a success. Oh I almost forgot, everyone is so interested in people s age. This person was 86 years old !!!!!!!!!!!!!!!!!!!!!!!!!!!!! And what is more the surgeon told us that he had done surgery on a couple of people several years back. One was 88 or so and the other around 90. Both of them are now over 100, so " compared to them this new patient was " young ", And whats more is that this new patient did not need a transfusion, no bag, no chemotherapy, no ratiotherapy. So it is a blessing. Respect your elderly parents who gave you life to come to this world. Show some appreciation for them by giving them care. Stop telling them to jump off the bridge literally. The hospital by the way is in the Northeast in New York.

my feelings would be to just let your dad live out his life without telling him. telling him could trigger a negative effect and harm his health even more. at that age there is really nothing that can be done for him. he is to old for treatments and surgery is out of the question. for him to be put to sleep for a procedure its a risk to say the least.
my dad was 90 when they told me he had cancer. I thought long and hard about telling him. dad had other health issues that would take his life before cancer so why upset him more. dad lived to be 93. he passed a few months ago...
the time that dad did have left he enjoyed without any worry of cancer....he was happy to the end. I miss him so much...

Paulcar, I could not agree more with your comment on page 1 (haven’t read rest of answers because I felt yours says it all!).

Many people don’t seem to be able to understand that for anyone really, no matter their age, living knowing that they have cancer versus living not knowing it is like living in two different worlds. Of coure if one is younger one has the right to know to then decide...and yet then if it is found at an stage where it is simply not curable..I would still understand the choice to not tell.

At 90? I would not even hesitate! The Calvary a person lives with the treatments you’ve to endure is not comparable to the “benefit” of a couple of more years to live...specially because the QUALITY of life after cancer treatments can be terrible, more so at that age.

Life ends for all at some point. At 90 I think God has allowed that person to live a long and hopefully good life. Time to be grateful for that life, and also to be grateful for the opportunity to know we can say goodbye the way we want to and surround our loved one with exactly that, love! It is actually a great gift, if we look at life through a realistic prism.

My mom and I have talked about this extensively, as she is already a survivor of non-Hodgkins lymphoma. We caught it very early (altho' if I had relied on what the doc said we would NOT have done a biopsy and would not have caught it so early) and she is clear that she would not want to go thru' chemo and radiation at her current age (88) if diagnosed with cancer again. She did well with the chemo (as these things go) but the radiation was very hard on her. Her teeth have still not recovered; she lost another upper just last week. I know what she wants if she has another cancer diagnosis -- palliative care and hospice as necessary. Trying to live forever is rarely the answer, although our Western culture is so death-defiant that we seem to try to do so.

My dad had cancer at 94 - FYI .. I have even heard of cancer of the placenta - it can come up at anytime, any place, any one - just because he got that far without it is good

I believe that the reason we have so much more cancer now a days is antibiotics because IF YOU DON'T DIE AT 6 OR 12 OR 17 OR 35 ETC DUE TO INFECTION MEANS YOU CAN LIVE LONG ENOUGH TO GET CANCER IN YOUR OLD AGE - our chances of hitting 80 are great & 90 is good as well but basically we actually have to die of something AT SOME TIME

I don't mean to make light of your dad's situation but just want you to see a perspective on it - I really hope your dad does as well with his that my dad did but be prepared that people in their 90's are knowledgeable about the side affects of radition & chemo so may allow some surgery [like dad did] but will refuse anything further treatment because they know that they don't want months of therapy that makes their life miserable in the short run .... they know it won't be a 25 year run so will go with comfort in the short time - the type & kind of cancer need to be known but some will say 'to hell with it ... I've lived a long good life so what will be will be' [dad's words not mine]

Depends on the cancer, proposed treatment, and patient’s wishes. My dad had colon cancer at 87 - huge blockage. Heavy bleeding. An obstructed colon is a ghastly way to die. He chose what the Dr recommended: therapeutic surgery (no follow up chemo) to remove the blockage. The surgery worked - cancer hadn’t spread to nearby organs. He lived another 18 months. He was very frail and had hospice care, but had a few more enjoyable family and church times in that period.

My 92 year old aunt played golf everyday and was diagnosed with Merkel cell skin cancer (rare, worse than melanoma, usually fatal). Her dermatologist believed it shouldn’t be treated & told her radiation would cause her teeth to fall out (tumor was on her chin). We wasted precious time - she had a strong will to live and waited to seek a second opinion with a dr who treats this cancer. What the research shows is that elderly folks who are relatively healthy can withstand radiation (chemo’s a different matter). In the case of Merkel Cell skin cancer, radiation is very effective if started immediately (within a few days of diagnosis). I know someone whose 85 year old grandmother was treated correctly after a Merkel Cell diagnosis and lived another five years, dying of something unrelated to the Merkel Cell skin cancer.
Best answer - do the research. Some patients will want treatment. Lots of variables when it comes to recommending cancer treatment for seniors.

My 78 year old cousin recently died of colon cancer after surgery and chemo. It was all very painful for her, when palliative care would have been best. I worked at the American Cancer Society for years, but they also recommend palliative care in some instances. It is certainly what I would choose for myself.

First, age is just a number. My great aunt lived happily and productively in her own home until age 102 (with a little help now and then from her kids and grandson for tasks like changing light bulbs on the stairs). She was even attending college classes up until two months before she died. Our neighbor lived well and happily to the same age, her twin sister outliving her to age 104 and getting interviewed by the local paper and TV station in her 104th birthday and making good sense.

On the other hand, my mother began to stand in death's door in her late 60s. She lived happily with lots of care doing things she loved 11 years longer than her doctors imagined. My Dad is 86 and suffers from FTD, a particularly cruel form of dementia. Every person ages differently and there are no cut-and-dried answers.

I understand well the concerns about general anesthetic in the elderly, particularly if there is dementia. I have gone to great lengths to avoid it for Dad (and super grateful to a hero surgeon who removed a nasty fast-growing squamous cell carcinoma from his temple using only local anesthetic). The subsequent radiation therapy took a toll on him, but he was back to baseline in a few months and enjoying life as he can now.

That said, even younger patients get Post Operative Cognitive Decline, and it usually clears within days or weeks. This might stretch to months with dementia patients and the elderly. Research this.

Sometimes it is cruel to put a fragile elderly person through surgery or other medical treatments, especially if they are unlikely to survive the treatment of have miserable quality of life afterward. Other times, it is worth it and the patient enjoys more years of life and health.

I know it is hard to get hold of and pin down the doctors and surgeons in the hospital, but if you want to be confident in your decision, do try and do some research first and ask them lots of questions.

If you decide surgery, etc., Is not in his best interest, then you can research says to make him more comfortable and keep the colon cancer somewhat at bay (and control the diarrhea). Things like butyrate and bioavailable curcumin come to mind.

It really all depends on your father's attitude, state of health, and other health issues. I know this is really hard for you and wish you the best! More info would be helpful, if you want tailored advice.

Chemo effects the heart. If his heart is not good, wouldn't attempt it. Make sure they tell you the side effects after chemo. It effected a friend of mines legs. They have to tell you pros and cons. In my opinion, if willing, they use people as gennie pigs.

Depends on a lot of factors. One, is your father in good health and mental status? If yes, does he want to get treatment? If he can't make that decision due to dementia, etc. then treatment would probably be traumatic and would it benefit him to extend his life in the condition he is in and for how long would it extend his life. Would treatment leave him more dependent on someone...would it leave him nursing home bound...what are the other risks for someone his age? Personally unless I was in great health and living a good productive life, I would not want to go through cancer treatment at 90 unless the odds were really good for a reasonably good recovery. I wouldn't want to add 3-5 years to my life if I was already suffering from Alzheimer's or another illness which would be made worse by any surgery or treatment. It has been my experience with my mother and a friend that anesthesia even from minor surgeries makes memory issues worse. Hope this helps and I am so sorry for you and your father's situation.

i have recentley lost my darling mum to dementia,bone cancer and lung cancer,she was on no treatment till she went in hospice for the last 3 weeks of her life,where she was kept pain free and clean and really looked after,they would talk to her when i wasnt
there and she was never lonely.eleven years ago i lost my husband to lung cancer and he had chemotherapy and radiotherapy and was in agony from the treatment for over 12 months,in and out of hospital with no life at all. what im trying to say is mum was 96 years old and was kept calm and pain free ,my poor husband was 67 and in a lot of pain, and had no life for 12 months because of the treatment, iwould want to go the way of mum,peaceful.

My Mom (who is now 94) said, 10 years ago, that if she had cancer she would not treat it. "Why should I?," she'd say.

Treatment may prolong his life, but to what extent? Would they even treat him?

I know that I would not treat my mother, age 91, if she were diagnosed with cancer. She says she has lived long enough. All her friends are gone. She lives with us and has dementia. Sometimes it's best to let nature take its course.

DementiaRN, excellent comparison and advice.

Two weeks before my mother's 82nd birthday, she received a diagnosis of lung cancer. She had no symptoms then. It had been found on a chest x-ray during an ER visit for a minor, unrelated need. My mother said, "Thanks for the info," and got the heck up out of there. She wanted no parts of "the poison they're selling."

Within a month, a close friend of my mother's was diagnosed with brain cancer. Her friend took the opposite course from my mother's. Surgery, radiation, multiple rounds of chemotherapy.

A year and a half later, my mother and her dear friend flew away within six weeks of each other.

My mother's friend spent the last eighteen months of her life tethered to a cancer center that was a 45 minute drive away from home. She was constantly either in the hospital or making 4 to 6 trips per week to the center for "treatment". Her 85 year old husband barely survived the experience himself.

On the other hand, my mother had over a year of being healthy enough to come and go as she pleased, to enjoy doing the things she loved most to do before she became tenuously ill. Only the last few months of her life were marked by fatigue, shortness of breath, and pain. By then, she was on hospice care. Her symptoms were difficult but manageable. She died as she had wished, at home with my father, my brother and me at her side.

I can't tell you what's right for you and your family. I can tell you I have never been so relieved or so proud as I was the day my mother said, "Thanks for the info." and got away from doctors and cancer treatment as fast as she could run. You already know in your heart what is right; don't be afraid to listen.

I think he needs to be helped because they are not acting right about it. I don't think he needs any kind of bad drugs. He needs to be having a nice feeling like the sun on him, and trying to do things to promote a good feeling. I wanted to tell you that some people have been acting like people who have cancer need to be treated like trash. They didn't treat me right when I told them I was ill with it. I did a lot of healing and they were not acting right. He doesn't need people trying to tell him what he needs to heal. He needs to ask God.

I remember walking with a 96 year old lady on her way to surgery one day.

She was having a double masectomy.

I wondered how much information she and her family had and how much money was shaping their decision.

My 60 year old niece had told me what she faced after surgery.

Of course i couldnt voice an opinion to the lady and her family.

I have a philosophy i call the road less travel. Yes i know there are other philosophies called that. This is mine ...

You have two choices ... one thing or another. You have to think awhile and chose the one you think youll regret the least later down the road.

At some time with the age involved no matter what you do tho youll need pallative care and/or hospice. They are 2 different things.

At 90 I would leave well enough alone.
Actually if he/the family decides no treatment then I would contact Hospice. (You can never go wrong in calling and getting someone on as early as possible)
You will have support,
You will get all the supplies you will need
You will get all the equipment that you need
You will have physical help in the form of a CNA as well as a weekly visit from a Nurse
You will also have the support of a Social Worker, a Chaplain as well as Volunteers if you choose to take advantage of these services.
Hospice will have necessary medications delivered
The main goal when it is necessary is to provide pain relief, comfort, support.

I think I still regret the decision I made to have a Melanoma removed from my Husbands head. I wonder if it would have made a difference in the 12 years of Dementia that we went through. (Never regret a decision that was made that seemed right at the time..)

I am not a physician but working in a cancer center PEPSEE is right on the mark. If its Prostate-do nothing. His age will get him b4 that type of cancer.