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My 95y/o has been diagnosed with aggressive skin cancer with possibility of metastasis. The tumor will be excised but it's possible it has spread. Doctor has advised PETscan which would detect other cancer cells in the body but has explained that the next step could be chemo or radiation and leaves the decision with family. Any first hand experience with how a 95y/o in only fair condition would tolerate these therapies?

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I have stage 4 melanoma skin cancer that spread to liver, lymph nodes, bones and spine. The immunotherapy used to treat the cancer was SO toxic to my body that the side effects are permanent, including bad vertigo, tinnitus and Uveitis in both eyes to the tune of such poor vision and issues that I now have cataracts and glaucoma as side effects from the eye drops. I've had to have spine surgery and 2 hospitalizations so far, not to mention monthly infusions to try to calm down my ramped up immune system and inflamed central nervous system. To no avail. I also have neuropathy in my feet as a result of the TWO treatments I was given.

I was 65 when diagnosed. I'm 66 now and alive, but the quality of my life is forever compromised.

There is no way on God's green earth I'd even give the poor soul surgery to remove the tumor.

Hospice is the kindest way to go now, to allow her comfort at the end of her very, very long life. Allow her to pass with dignity and grace. Please.
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Dawn88 Apr 30, 2024
I'm so sorry you are having this situation. Very sorry. Tears are rolling down my face typing this. You are a strong woman with a heart of gold.
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Did you ask the doctor what the life expectancy is for a 95 year old with this cancer and how much time these treatments would give your parent? Also what are the side effects of the chemo and radiation? Is it worth it? My answer at that age would be no. But some people keep on keeping on regardless of the side effects. When you say fair condition of this person what does that mean?
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I am an old retired RN, 82 this year.
I have had my second diagnosis of breast cancer (first 35 years ago) this year.
I accepted a lumpectomy. I will not take radiation. I will not take chemo. I have had them once and won't be taking again. The cancer will spread if/when/how I cannot know.

There are indeed MANY things I will not now accept. They are all written in my advance directive. I will not fight to live. I have HAD A LIFE and a good one and I am content now to go. I would never have feeding tubes of any kind nor dialysis, nor pacemaker. I would go to palliative care and then to hospice. It would shatter me to be a burden to my family, to force them to watch a slow and torturous demise.
My family knows and is supportive.
My doctors know, and my wishes are scanned into my chart and they agree with the laws of my great state of California to avail me of MAiD (medical aid in dying) cocktail when it is judged that I may have fewer than 6 months left.
The emphasis will not be on prolonging of my life.
It will be on a peaceful journey to my death.

So that's my choice for my life.
What about your beloved 95 year old?
What does SHE WANT for her end of life wishes, because that is what she is now approaching.
I wish the very best for you all, and will tell you that this is an individual decision. She is the one with the choices. If she cannot make them, then the person who is assigned to act for her best interests, and who knows and loves her, should make those decisions for her.
People are all different.
They approach this with decisions individual as their own thumbprints.
I wish for comfort and for peace and for minimal suffering for your loved one.
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ElizabethAR37 Apr 30, 2024
Absolutely agree! Personally, I have already outlived much of my body's usefulness at 87. I certainly would not choose to prolong my existence if I develop cancer. One can never say never until confronted by a specific situation, but almost certainly I would opt for palliative care, then hospice--especially if I were 95.
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Please listen to our dear Lealonnie1. She writes before me.

She has suffered so, and it's been hard for all of us HERE to "watch", and we're not even her family.

If it were my mom going through this, after reading about the horrors that LL1 has gone through, I would immediately call hospice and get them on board. I would never put my mom through that torture.
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Radiation is one thing, but having personally observed the effects of chemo, which landed my mil in icu at least three times at 77, i advise against it.
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My dad was a very active 92 when he had chemo. He walked twice a day, went dancing on weekends and went to his office every weekday. He went on cruises all over the world and drove on long car trips every 6 weeks. The chemo made him so sick that he stopped it and went into hospice. It took him a few months to die.
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One thing that has stuck with me from Atul Gawande's book Being Mortal is that there is often a disconnect between the expectations of the patient and the doctors promises are made of a treatment extending life, and even his own medically trained family fell into this trap, the doctors may mean extra months but the patients may believe the treatments will buy them much more time than that. I think you need an explicit explanation about this in order to make a good decision.
I have a friend whose father had a rare and aggressive tumour on his face and they did opt for treatment and he's still with us a couple of years later. But they were also willing to stop at any time if the treatment became too difficult.
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Isthisrealyreal Apr 30, 2024
This!
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Maybe ask the doctor what would he do if it was his loved one , or even if it was him at 95.
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cwillie Apr 30, 2024
In my experience this strategy has been used often enough that doctors are wise to it and can dance around this with as much skill as a politician asked a direct question.
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Me, I would never put anyone age 90 and over through something like this.

She is 95, let her be, how long exactly do you think she will live in the first place?

Chemo will shorten her life, her remaining good years will be torture.
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The tumor can be removed but radiation can wipe Out the Life force .
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sp196902 Apr 30, 2024
Same with chemo depending on how strong it has to be because it kills your entire immune system.
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