She is generally otherwise in good health What advice would you give for treatment, bearing in mind the side effects of radiotherapy at her age?

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My father, at 85, decided not to treat his colon cancer. He would have needed treatment for a potential aortic aneurysm before surgery. Either operation could have killed him. He lived 8 more months, and did not suffer horribly.

Honestly, 20 years later, I still second guess his decision from time to time. Maybe we should have poured the antidepressants down his throat and pushed him to get the surgery. He second guessed himself, but I think he had had enough of life. Maybe it would have been less painful for him to die during surgery than to linger.

I hardly even believe in any god, but in this sort of matter, I am driven to say that the outcome was God's will. It wasn't under MY control!
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Lenna, it certainly is your mother's decision, and should be as long as she's still capable of making that decision.

Some unanswered questions you might ask her doctor could be:

1. What's the prognosis if she were to go through surgery? What specific surgery would it be, and how normal a life could she live thereafter?

2. What's the prognosis if she declines surgery?
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I am so sorry that you and your mother are facing this diagnosis. Hugs to you both.

Mother does not want surgery. Does she want any kind of treatment? What is her attitude toward this diagnosis? I think that is the single most important consideration. As cwillie suggests, having her options explained is a good and necessary first step. And then the options can be compared to her goals for herself.

Several years ago I was in the geriatrician's office with my mother. The doctor brought up a spot that had been found in her pelvic area during routine imaging for other reasons. She offered to arrange for further testing. This was their conversation:

Ma: No, I don't want further tests. Whatever it is I don't need to know about it.
Dr: I respect your decision. As your doctor I need to tell you that if it is cancer it could be treated. Cancer treatments have improved greatly over the last few years.
Ma: I would not go through the treatments. So there is no point in the tests. I have lived a good long life. I'm going to die of something. If this is it, then that is the way it is.
Dr: Many of my patients feel that way. I will not try to talk you out of that decision, but I will tell you that if you change your mind I'll be happy to arrange further testing.

Well it was evidently not cancer because mother is still with us, in a nursing home with dementia and mobility problems. I was glad to be present during the conversation with the doctor, and I shared it with my sisters. I don't know if my mother made the "right" decision but it was certainly her decision to make.
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I recently read an amazing book call Being Mortal by Atul Gawande, in which he discusses the inevitability of death and the struggle to find the balance between continuing the fight for life and letting go. Some treatments may be palliative, meaning that they can relieve symptoms and improve her quality of life. Others are a misguided attempt to avoid the inevitable and can cause her last months to be h3ll on earth. Often the difference in life expectancy between those who fight and those who surrender gracefully is only weeks or months. I hope you can find someone who can sit down to rationally go over her treatment plan point by point, weighing the pros, cons and importantly, the outcomes of each choice.
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