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My 87-year-old mother is going to be starting radiation for mouth/neck cancer. They are strongly encouraging a feeding tube.

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Make sure mom understands that what is termed a temporary could easily turn to permanent. My mother had a feeding tube placed “temporarily” while doctors told us she had a great chance of recovery, different circumstances than your mom, my mom had a huge stroke. The recovery never came and as she was mentally intact and completely aware, it wasn’t like anyone could face pulling the tube. Have a thorough meeting with the docs involved and be sure everyone understands the prognosis and is on the same page. I wish you peace
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Depending on how bad the cancer is and how much radiation they are going to use and for how many treatments it can be brutal. I attribute radiation like getting a first, second or third degree burn. With the extent of said burn determined by course of treatment.

Since they are recommending a feeding tube I am assuming it is going to do a number on her throat and mouth making it too painful for her to eat?

What has the doctor said about the pain the radiation will cause from just the simple act of swallowing your own saliva which we all do involuntarily who knows how many times a day.

My dad had throat cancer but it was caught early enough that he did not have to have very many treatments and he was still able to eat without any pain or discomfort. He was lucky. There are many who are so damaged by their radiation treatments that they are in constant pain trying to eat normally afterwards.

Hopefully mom is prepared for all bad outcomes before deciding whether to proceed or not. What is life expectancy with treatment and without.
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My 83-year-old father was going to need a feeding tube due to a medical complication. He had clear directives that he never wanted a permanent feeding tube so he was admitted into hospice. It was a really hard decision as I knew he was going to die, but I was thankful I could follow his directives and didn't put him through any unwanted medical interventions that would significantly impact his need for care and quality of life.

Does your mother want a feeding tube? I would ensure that you are all prepared for her to have a feeding tube as that is the more likely outcome. If she has health directives or you can discuss the situation with her, I would.
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I recall my Mom having (way back in the dark ages) surgery, and then the "cobalt" treatments that she had were probably far more damaging than what is done now.
My Mom did not have a feeding tube. (Mom was in her mid 40's)
My Mom had cancer of the throat and larynx.
My Grandma had a tube that my Dad would give her nutrition through, it was a tube that went through her nose. (trying to recall all this now, it is difficult to remember I was so young) She eventually did get off the tube feeding. (she was in her late 80's I think)
My Grandma (maternal Grandma by the way) had cancer of the jaw and 1/2 of the jaw was removed and no reconstruction was done this time (a previous surgery that had removed a portion of the jaw was rebuilt using rib)

I guess the big question is how does your mom feel about this?
She is the one that the doctor should be addressing this to. She is the one that should be making this choice.
After all it is she that will be going through this.
And I guess the other question is if she wants the feeding tube does she want it temporarily or would she be alright if it is permanent?
I hope she is also aware that opting out of the surgery is also a valid option. Quality of life is more important than quantity. And if this is a decision she makes that the family honors it.

And a side note here...If mom is competent she should be making this decision, if she is not competent I would NOT opt for surgery of any kind.


And the bigger question is, if she would want it only as a temporary measure are you alright with that decision.
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AlvaDeer Apr 2022
I agree. I would not want this surgery at now 80. Were I unable to make this decision I would not want this radiation and the outcome. Would want hospice. Because I was an RN I know to make my advance directive full of addendums and instructions about things and one of them is my refusal for artifically given nutrition whether IV or NG or PEG.
This MD in this case is I think being honest. Is essentially saying "Are you certain you want to go through all of this".
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My brother had throat cancer and couldn't swallow or eat when undergoing radiation. My mom was begging them to insert a feeding tube because he couldn't eat. He went from 180lbs. to 111lbs. in 6 months and passed away 11 months after diagnosis.

I will say that without the feeding tube, his passing may have been sooner since he was getting absolutely no nutrition and very little hydration.

My point being that your mom will not be able to take in any nutrition without one.
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Yes to the feeding tube. It’s a must. No questions.
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I had radiation with stage 4 cancer & survived. My father did not want radiation at age 87 but I encouraged him to do it since I survived. He went through radiation. The day he finished he was admitted into the hospital and dies 5 days later. Although I wanted him to do this, it was too much. I wish I had kept my mouth shut. He wouldn’t have suffered so much. Radiation is tough. I was bedridden on day 4 of my radiation.
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TChamp Apr 2022
All depends on the site of the tumor and its type. For example, most prostate cancers are slow growing. However almost all ENT tumors are lethal regardless of treatment.
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I agree, my DH lost a friend a while back who had throat cancer. He fought it for a couple of years. He was a health nut. Kept his weight down, active and I don't think ever smoked. He was in his mid seventies. I think at her age, I would not put her thru this if its not going to prolong her life significantly. She maybe better off going on Hospice and let nature take it course. I woundn't put her thru this.
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I'm sorry to say that her cancer seems to be incurable and lethal. An 87 year old person is not likely to survive and the treatment will be useless. What will she gain by prolonging her suffering?
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AlvaDeer Apr 2022
I so agree. But often MDs are not honest with the amount of suffering for likely little reason. They will often not be honest about options for a better death. I hope the OPs MDs have been honest with her Mother, with her if Mom is no longer competent. Much treatment late stages of cancer in the elderly amounts to no more than torture and prolonging of a miserable life. BUT this is an individual choice to be made by the person, or by the person's POA who hopefully understands what the person's wishes would have been were they competent.
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Is it your mother's wish to get radiation for this cancer? Is she fully aware of what the side effects are and how it will affect the quality of her life moving forward? Is she aware that she does not 'have to' get radiation and can choose hospice care instead? I hope you and her other children are not the ones pushing for her to get treatment at 87 years old for such a cancer, which will have a profound effect on her forevermore.

If she is choosing to have radiation, I don't think she has much choice about a feeding tube, meaning one of the biggest pleasures in life will also be taken away from her: eating food. This is a very serious undertaking for a woman her age, really.

Wishing you and your mom the very best of luck
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You ask "Is it true that there is a 90% chance she could never come off the feeding tube".
I know that you didn't pull that out of thin air, so I am assuming that the physician has told you this.
If the MD told you this you should know it is the most likely thing to happen.
Also understand that radiation therapy, especially in the elderly, causes burns and scarring in delicate tissues that can obstruct.
Is anyone leveling with you here, and with your Mom, about the alternative choices that may be made for palliative or hospice care? Have you clearly been told the chances of this not only not being curative but in fact causing further complications and pain?
If you are fully informed, and if you are fully aware, of all possible/probable outcomes including loss of speech and swallow being possible, and Mom wishes still to make this fight, then that is her choice. But, yes, believe your doctors.
Now if some neighbor from across the fence is telling you this information, disregard it.
You are in the hands I hope of competent doctors who are being VERY HONEST with you all. I am so sorry about this dire situation. I hope for the best for your Mom.
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That's a really good question for her doctor, but if she's starting radiation soon for cancer in her mouth and and neck, don't you think it's in her best interest that she does get a feeding tube so she can at least get some nutrition during her treatments, as I'm sure her mouth and neck will be pretty raw from the radiation, and she won't be able to tolerate any chewing or swallowing?
I'm not sure she really has a choice in this matter if she's wanting to proceed with the radiation, do you?
And as far as the feeding tube being removed or not, you can cross that bridge if and when the time comes.

My husband had a feeding tube surgically put in after he had a massive stroke and he wasn't able to swallow. After a short time his ability to swallow returned and his feeding tube was removed.
I think everyone's situation is different and you would like to think that your mother's doctors will do what is best for her.
Praying that everything goes well with her treatments.
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TChamp Apr 2022
Sequelae from a stroke have a good chance to improve. Neck cancer has zero possibilities for improving.
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