My mother (85) has moderate dementia and ovarian cancer. Doctor is recommending chemotherapy. Anyone have experience with this?

My aunt was diagnosed with cancer at that age. Her children insisted she try chemo because they couldn't bear to lose her. It made her so sick, she stopped after two weeks. She died about two weeks after that. The tragedy was that those first two weeks -- such precious time -- were wasted on being horribly sick. All her kids regret pushing her to do it.

Ask the doctor what he expects to accomplish with the chemo. Ask what she can expect FROM the chemo. Ask what to expect without the chemo.

My personal opinion: life has just given your mom and you a get-out-of-jail card. Dementia is a HORRIBLE disease, worse than the cancer she is having. I would not go thru with the treatment and let her die with dignity. Dying from dementia is a sad, sad way to go.

My husband has advanced dementia and I know if he was still lucid, he’d choose death from cancer than dementia.

It is well-known in medical circles that chemo in the elderly simply makes them wish they were dead due to the HORRIFIC side effects. Opt for quality like your mother expressed. Doctors recommend chemo, but perhaps not for the reasons you think. On average, chemo treatments cost $7,000 each--the doctor receives about half of that if not more. So what is the true incentive here? Health care is big business and doctors are part of it. Things have dramatically changed in the past 10 years. Everyone is looking for their pockets to be stuffed though people want to believe their doctor is truly looking out for their best interests. Behind the scenes is a very different story. As a nurse, I have witnessed many a discussion between doctors regarding how much they can make by ordering certain drugs, sending patients to physician-owned facilities, etc. Perhaps we should ask why is it that we are using the same junk chemo we used in the 1970s...are we to believe that in over 50 years we can't come up with anything better? No. It's about money. In one study of >1,000 doctors, MORE THAN 70% said they would never want or consent to chemo. Why? Because they know it simply makes you so miserable you will welcome death. Let your mother have her quality time and tell chemo to pound sand!

Chemo will not cure her cancer. It will prolong her life. Since she didn't want to treat cancer before she had dementia then I would not put her through chemo now that she does have dementia. She will not understand why she feels so sick and tired after treatments or why her hair is falling out (if that happens) or why any number of terrible side effects are happening to her. Good that the surgery went well. I would leave it at that and get her a palliative care consult so that her pain is treated and the focus is on her quality of life.

Ask the doctor, in your mother’s presence, how long the chemo will take, and how much longer she is likely to live after it is finished. Let her decide. The following was my mother’s story from breast cancer..

My mother had got 10 good years from chemo and a mastectomy, aged 68. It returned she was 78, and the cancer had metastasised throughout her abdomen. The oncologist operated to remove all (?) of the metastasised material, and was pressing her to have another 6 month of chemo and radiotherapy. Her physician did not agree, but was not prepared to oppose the oncologist. I asked the oncologist, in mother’s presence, how much longer she would be likely to live. The answer was 8 months to a year, and that included the 6 months chemo.

My mother then understood exactly what she was facing from another round of chemo, and what she stood to gain from it. She refused immediately. She lived another few weeks, comfortably emotionally and in no pain.

This might be me sitting on the fence again but...
If mom is aware enough that she FULLY understands what the diagnosis is, what the treatment involves along with all the side effects AND what the chances of them curing the Ovarian Cancer is then she can make an informed decision.
BUT
I would not want to put my loved one through chemo.
I would opt for Hospice at this point.
There is a VERY good chance that they did not get all the cancer and she would have to undergo more surgery
She may have done well with the anesthesia this time but next time it may not clear her system as well.
As she declines each chemo session will become more difficult.
And there is a "chemo fog" add that to dementia.
I am so sorry...
((hugs)) for you and mom.

Simple words ... I often think mans medicine gets in the way off God’s plan.....

Thank you all for your thoughtful comments. To answer some of your questions, I have POA financial and medical. My mother has short-term memory problems and some paranoid/delusional thinking, but operates very well in her own space.

We don't really have enough information to make a decision. The tumor is a fourth stage cancer, a slow grower that may have been there for many years. As I understand it, the grading is what determines life expectancy. We won't have that for another couple of weeks.

My mother bounced back incredibly from the surgery. Up right away and no pain, ever! She was very energetic before and is still. The doctor told us he recommended chemo, but that she was free to tell him to go jump in a lake. He also stated he thought she would handle the chemo well.

You say your mother has moderate dementia - is she capable of making informed decisions? If so, ask the dr the purpose of the chemo is. Is he talking cure, remission, prolonging life? Try and get as much information as you can - ask the dr what he'd do if it was his mother (he may not answer that question, but ask it anyway). If your mother is capable of understanding and making an informed decision, then try and follow her wishes. If she can't, then someone else who has the power to make the decision needs to make it for her.

It's hard to know what to do especially for someone else. I have always tried to make informed decisions, however, there are times I make what I think the best decision is and hope I got it right. I wish you and your mother the best and that whoever makes the decision and whatever the decision is you will find peace that you are doing the best you can. That is all any of us can do.

I'm the caregiver for a cousin with dementia, who was diagnosed with a massive and very aggressive sarcoma about two years ago. Though her dementia was moderate at the time, she definitely didn't have the capacity to understand all the implications of the diagnosis or treatment, which involved surgery and radiation (but no chemo), so the ultimate decision fell to me. As her caregiver, it was a difficult position to be in, because if I'd asked her before she developed dementia whether she would wanted to be treated for cancer when she already had Alzheimer's, I'm pretty sure she would have said no. (I think most people would probably say no.) But when faced with the decision in a specific situation, I discovered it wasn't so clear-cut. I had a long conversation with the doctor about what her quality of life would be like with and without treatment, since her quality of life is what I most cared about (and what I'm confident she would have most cared about, too). Based on that conversation, I concluded that she had to get treatment because without it, her end of life would have been prolonged and horrible, and she would have suffered immensely, without understanding why she was suffering. Honestly, if that hadn't been the case -- if she could have had a peaceful end of life with her type of cancer -- the family and I might have made a different decision on her behalf, because I don't think she would have wanted us to prolong her life with cancer so that she could have a long slow decline from Alzheimer's. But given her prognosis, I think we made the right decision: The surgery and radiation wasn't fun for her, but in her case, it was clearly the lesser of the evils -- two very difficult weeks (she had a specialized intense radiation over a short period of time) vs. what would likely have been months and months of misery. She's now almost two years past the surgery and she's had a pretty good quality of life, even with the Alzheimer's. I want to stress that all of this is specific to her type of cancer, and I do recognize that the picture could be very different for someone with a different type of cancer. I also would never presume to speak for another family's choices. But I do think that if you keep her quality of life in foremost in your mind, it will help to guide you. Best wishes with this, and please keep us posted -- it is a very difficult position to be in both for everyone concerned.