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

I think someone touched on this already but if I were you I would consult her PCP and any other doctors she knows and trusts. Specialists often see their lane rather than the big picture. What I mean by this is the Oncologist see cancer and the treatment of cancer rather than the 85 year old with moderate dementia. They don’t clean up after the treatments her primary does that most of the time (some places have a cancer primary if you will as well as several specialists and do treat the whole person all the way through clean up) once the cancer has been treated as best it can be which might be surgery, chemo, radiation...they follow the patient once every 6 mos or year to check for cancer. The more advanced your age especially with cognitive issues already, the higher the possibility there will be further cognitive decline, this applies to any surgery that requires sedation not just cancer, a mind and body can only handle so much. My point being it isn’t really about how good of an oncologist the doctor is he or she is an oncologist and they are trained to treat cancer, get rid of it if they can so I would consult her primary who is trained to treat and farm out the whole patient and or any other specialists who know her. Ask the question suggested here with mom in the room of course, “what might the benefits be and what will living through the treatments be like, what could the permanent side affects be? What would you suggest your 85 year old mother do in tI situation”?

Good for you asking the questions and doing the research by the way, not simply jumping in to treatments. This is not to say when you have all the info you need chemo won’t be the path you both choose of course but better to go into it with eyes wide open rather than tunnel vision. Thinking of you through this battle.

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!

I have cancer. I go to chemo. I don’t do radiation as yet. The days after treatment are hard. I don’t feel well and it takes time for me to feel better. Has the oncologist done tests to see if the cancer has metastasized? Have they told you that they got everything out? My mother is 95 yrs old. She has breast cancer. She chose not to treat for it as she has so many other health issues too. It is hard to stand by and watch and wait. Our first instinct is to treat and cure. But sometimes curing is not in the realm of possibilities. Does your mom have any other health issues that would factor into whether or not to treat besides mild dementia? I’m curious to find out if the cancer has spread. If that’s the case, it is difficult to chase that around the human body. Then they have to do a more aggressive approach and that is so very difficult mentally and physically. Quality of life sure plays a role in these decisions.

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

The long & short answer.....don't do it. If you are POA, you can make that decision.

The more that I think about this question, the more I am inclined to say to let her live out her remaining days in peace.

Chemo is so rough on the elderly. She’s 85.

Most of her years are gone. Let her know that you love her and when it’s her time she won’t be suffering from chemotherapy.

I will keep you and your mom in my thoughts and prayers.

Advise: How does your Mom feel about Chemo? Does she trust her doctor?

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Honestly, I would question the motives of a doctor who would consider chemo for an 85 year old patient with dementia. My husbands mother died from a brain tumor. She had done the chemo thing, when the first round didn't work, she said she would NEVER do chemo again. It was so terrible.
My husband was diagnosed with colon cancer over 11 years ago. The surgery was a great success, but the oncologist wanted him to do follow up chemo. I researched the side effects he would deal with and he said NO. The chemo would have made him an invalid for who knows how long. The surgeon was thankful when my husband made that decision because he didn't think it was in my husband's best interest. My husband is 68 years old, still works full time, is planning to expand our garden this year, and is SO thankful he did NOT do the chemo. Ask the doctor if he will be there to clean up the vomit.

No matter what you decide, I would advise you to request a copy of all that is discussed in each doctor's appointment. Let the doctor know that you are expecting this. I am often amazed at the lack of detail in doctor reports that represent a visit. Knowing she couldn't count on her memory my mom used to ask for the notes before leaving the doctor's office. I thought that was very smart of her. With those notes in the official print out from the doctor is an excellent point of reference for those discussions that you will likely have with your mom. No disagreements as to what was said. As to her moderate dementia, was there any conversation regarding the cause of it in the light of her cancer diagnosis? Could there be a causality not considered before? Some conditions can look like dementia when in fact it is something else. Your mother may have felt confident about not accepting treatment in concept, but when confronted with the reality, she might have felt differently. Surgery is treatment, and she accepted that. Did she weather the anesthesia well without any deterioration of memory? Try to gather as much information as you can, and support her decision. There are no perfect answers but there are answers that are best for the time.

I would ask about other options to Chemo! Everyone I have known that has gone through Chemo did not do well.

There are new things that are being discovered right now that sound wonderful. I truly believe we are on the verge for a cure to most cancers.

Im thankful she had the surgery and came through it well. It will prolong her time here on earth and enjoy her family. Enjoy each moment she is with you. As her dementia progresses you and siblings will have to make the decision what to do. Just remember her body will start to shut down the appetite , incontinence for 1 and 2 , so have home care come in a couple of times a week or hospice. They will help tremendously. My husband wouldn't eat anything but fried egg sandwiches so I was fixing these every meal. Don't stress yourself for you need to take care of yourself in order to take care of your mother. Sending prayers for you and family . God bless, He is in control.

How advanced is the dementia.? What are your mother's wishes? Does she have a living DNR? Has she given you her Medical Power of Attorney? Other than the tumor is her health really good? Sounds like a lot of questions, but she is 85. When Mom was alive, she said and put into writing all her wishes for her health care. It was a blessing as her Dementia was pretty bad. She always said she did not want any Drastic measures done to keep her alive. We did what was necessary to keep her going, comfortable, and happy, but nothing more.

It was tough to do, but I did find that only going on her wishes did make it easier in the end. I know, in both mind and heart we (me) what she wanted. By the way she lived to 98. God's blessings and care for both of you. This is not an easy time for either of you. Hugs and comfort!

What is her current quality of life? Does she have an advanced directive, durable power of attorney for healthcare, living will? Is she really able to make decisions for herself? Does the physician even realize she has dementia? Many mild to moderate patients can prevaricate enough so that they fool medical professionals who don't see them regularly and are not looking for it. Chemotherapy will make her miserable and may or may not make a difference in her life span, especially if her lymph nodes are involved and/or metastasis to additional organs. How long will the chemo last? What are the expected outcomes? Prolong her life, cure the disease, palliative? Lots of questions, and probably more, before a final decision is made. She might change her mind if asked again today. It will depend, somewhat, on how the question is asked.

My mother, at 75 told me they had spotted a lump in her breast on a mammogram and put her through stereotactic biopsy before she told me about it. I asked her why, at her age, she was still having mammograms? She said, "because the doctor ordered it" for her. The 'lump" she had was not cancer but fibrocystic disease, totally benign. If it had been cancer, the chances that it would have grown fast enough to be her cause of death were pretty low. Before she got the results, she had decided after a long talk with me, that she would not go through treatment as she had had friends that did who were miserable and regretted their decision to have chemo. She also decided to no longer have mammograms at her age. On her next visit to her primary care doc, she told him her decisions (no mammograms, no chemo for anything if something showed up, except palliative) and he wrote it in her chart. Luckily, this all happened prior to her mild mental decline when my dad died. She died at 82, 3 1/2 years after my dad died. She was miserable and depressed without him after 62+ years of marriage and I considered it a blessing for her.

As a clinical ethicist and having been through these decisions with both parents, I understand how difficult this time is. If your mother has dementia and depending on its severity, she may not have the decisional capacity to make decisions. Meaning that she can't comprehend or fully understand the consequences. Additionally, patients feel they must go along with the physician, who is in a position of power. As many have mentioned, chemotherapy often has toxic side effects that make patients' lives miserable in addition to traveling back and forth to the clinic. These are your options as I see it - 1) no chemo per her previous wishes to foster a better quality of life instead of increasing # of months/years, 2) low dose chemo to limit the side effects but may give her less time to live, 3) try chemo knowing you/she can stop at any time, or if life is more important than quality, take full dose of chemo in hopes of more time but feeling lousy. Ask your Mom if quality-of-life is more important than quantity of time and what that means to her. Tape the conversation and then revisit her physician and be firm with your choice. We had to be very firm about my mother's decision to have no chemo. Hope this helps and know that many of us understand and are thinking of you.

I pushed Mom to take chemo and she did it “for me.” The doctor had recommended against chemo for a patient in her 80s.

She was so sick after the 6th round she was saying she wished she would die. I regretted begging her to go through the treatment.

Her doctor took her off chemo because she couldn’t tolerate it. I think he was concerned the chemo itself would take her. The side effects created permanent damage.

If you are following her wishes, that is the most important thing. Sometimes people change their minds when they have all the facts and the scenario is no longer hypothetical. Although she has been diagnosed with some dementia, her brain may work more effectively when faced with a crisis.

These are difficult times and it is so wonderful you are there for her. Lots of people disappear when facing such challenges.

Imho, perhaps you should see what Stanford has to say.

If she is still able to make her own decisions then it is her decision to make. Have a serious talk with her. You can’t make a decision until the pathology report comes back . If it is cancer then it is best to ask the doctor what her chances are if she has chemo. Off hand I would say at 85 , if her chances are not good let her live out whatever time she has left without having to go through chemo.

Chemo is not always the best choice. It's a lot to put a younger person through let a long an 85 year old. That also has dementia. Just enjoy the time you have don't make her suffer.

I would definitely turn down the chemo based on her age and the dementia. Btw, A few yrs ago, I watched a documentary with a former oncology nurse and she gave alot of insight into the dark side of chemo. It ranged from side effects, cure rates, to it causing other types of cancer, and finally the profitability aspect. They said chemo is one of the only treatments where the Dr. actually profits from the use of the chemo drugs themselves. So, some Drs. are more inclined to recommend it for patients where it makes no sense. At 85 years with dementia, I recommend going by what your mother previously communicated. Good luck to you, wishing you all the best.

If this were my mother - or even me - I would definitely hesitate regarding chemotherapy. Take a really deep breath and think. You need to carefully research the side effects of whatever chemo is being prescribed. Is it an oral med or IV? What is your mother's life expectancy WITHOUT any treatment? What is the efficacy of the treatment being suggested. Believe me, there are statistics available if you look. Please, please, please get a 2nd and even a 3rd opinion regarding what the likely outcomes are with and without these drugs.
IMPORTANT questions to ask are: How long has this drug been in use? It is still experimental? Would this be compassionate use? How long will it allow my mother to live? Again, get more than one opinion; do your research. I am a retired oncology nurse. The practice I worked for dealt mainly with ovarian cancer patients. Best to you and your mother.

There is no way I would put my 85 year old mother through Chemotherapy. I'm sorry for the situation you are facing, but always keep in mind what your Mother would want and what you would want done to you if you were that age.

My mom ,my best friend in the world, died of lung cancer she had lewy body dementia and alzhiemers disease. She would not have been able to tolerate the chemotherapy and had told me years before to never put her through that. I am so sorry for what you are going through. So hard to see your loved one suffer with dementia and the every day decisions. When I took my mom to the hospital to have her biopsy she totally freaked out from the fear alone. One of the hardest decisions of my life to stop trying to keep fixing what I could not. Mom is in heaven now and she is at peace. She helped others in the end by donating her brain to Mount Sinai Research. They also helped me by my last question. Cure the cancer or let her live out what she had left. They answered ...Let her live out what she has left. Angels watching over both of you.

See that she gets her rest and good foods, antioxidants, keep her encouraged. Pray for the best and check periodically on her tests don't wait for them. Hope all goes well.

My Mother is 88. She has Vascular Dementia and was diagnosed with suspect Ovarian Cancer June 22 but no biopsy so it is considered Peritoneal Cancer, which is treated same as Ovarian. She is having Carboplatin IV Chemo treatments once every three weeks… She is on the 2nd treatment, After the first treatment the fluid buildup appears almost gone. The dementia seems ok at times. More agitation and wide awake from steroids given just prior to each treatment. Hope your Mother is doing well.