Fawnby Asked May 18, 2025
Should an 82-year-old man with stage 4 dementia get prostate cancer treatment?
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How likely is treatment of aggressive prostate cancer with metastasis to bones in an 82-year-old man who has stage 4 dementia? To me, hospice seems more likely than lifesaving measures.
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Why would it even be suggested that an elderly person with advnaced dementia take treatment for cancer? At 82 years old with dementia it sure seems to me like unnecessary cruelty.
Are you now qualified to make a dementia diagnosis? Former President Biden's doctors have never made any statement about him suffering from dementia.
When he did the debate he may have had a UTI or some other kind of infection. Who knows? Since you are not one of his doctors, you really shouldn't be talking about his "level of dementia" at all.
My LO was dx at stage 3 or 4.
Initially, hormonal treatment aim was to slow progression. Later, chemo & radiotheraphy aim was to attempt to shrink bone massess.
These were discussed frankly but not bluntly. I don't think we really considered the term *palliative treatment* until near the end.. yet that is what it really was the whole time.
I have mixed feelings. Did it all buy more time? Improve quality of life?
Or did the side effects hasten the end?
Did the hormonal treatment cause the brain fog? Or did the cancer cause it?
Was the pnumonia & infection storm that hit after the first chemo session worth it? Could that have happened at any infection anyway?
Was the intense bone pain triggered by the first radiotherpy session due to the treatment? Or by the bone mets & just a coinsidence?
What I saw was heartbreaking. But I was merely someone to hold a hand - the decision to take these not-so invasive & invasive treatments was not mine. I respected the decision to try.
Each person can react differently to treatment too.
But I know that experience left a deep impression on me.
I assumed stage 4 Prostate Ca, on top of existing Dementia.
I re-read it now as NEW Prostate Ca, with current stage 4 Dementia.
Very different stages of health, independance, prognosis.
Hopefully I was wrong the first time 😞
In 2010, I met a famous rock guitarist at a Battered Women's fund raising concert. I'd been a fan for decades, and was doing video. Afterward, I was backstage packing my stuff, when he asked me to talk privately. He asked me not to publish the video I took, since he was having a "bad night." He told me he just had prostate cancer treatment 2 days earlier, where they put "radioactive beads" into his prostate. He was clearly depressed, despite a great show. I told him my experience was it was curable, since several family and friends of mine had survived it. I pumped him up the best I could. I told him how important he was to so many people. He actually smiled and seemed better. I emphasized his cancer was found early, which was what would save him. I think he was scared to death, and who wouldn't be? He was in his mid 50s at that time, with a wife and no kids.
Six months later, I heard on the radio he had shot himself while fishing alone. It broke my heart. His treatment was not considered aggressive. He probably didn't have the right mindset, or his depression treated. Who knows?
My take is a man in their 80s would not tolerate aggressive cancer treatment. Both my late husband and best GF of 30 years had "aggressive" Stage 4 cancer treatments, and Brett (age 32) tolerated it, yet my GF (age 56) was violently ill and forced to stop. Both of them died within 1 year of their Stage 4 diagnosis.
The (alleged) "dementia" has nothing to do with it. Bone cancer is extremely painful, but is not the primary cancer. In the last decade, many new treatments have been developed. My Dad died at 50 after his heart attack in 1970, because cardiac bypass was not available yet. My sister (retired RN) had a triple bypass in 2018 at age 70, and has been fine since.
After the bone tumors appeared, he underwent further radiation, chemo, hormone therapies as palliative treatments, but it took only a year and a half before he died.
One uncle-- not related to father-- was fully cured of prostate cancer decades ago, but had different initial treatments and of course everyone's situation is unique...
I would suggest hospice for the "patient in question" above. It was a blessing for my father, and greatly eased the pain during his final months.
These are all decisions we make as individuals. When there is stage four dementia at work, then the quality of life is already not very special. And there is already some trusted family member in charge to see that what is bad isn't made worse by worthless and senseless treatments of devastating illnesses. This POA will be aware of the person's wishes, and will consult with doctors about what can and cannot be done for best end of life care.
It was his decision; it was as Alva said senseless and as his caregiver, it was torture for me as well.