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treatment or not for 89 year old mom ovarian cancer, Stage IIIC?

jphilli8
Posts: 5
Joined: Oct 2006

Is there anyone out there who can tell me what, physically, will happen, if no treatment of any kind is given to my 89 year old mother who, based on recent CATSCAN, I'm told has a 13.9 cm complex thinly septated ovarian cyst, most likely malignant (assume it is malignant). We're awaiting CR125 results. She has other symptoms, e.g. weight loss, loss of appetite, severe back pain, etc. Drs telling me that she has to have surgery, one way or other; if no immediate surgery, then they say that eventually cancer will grow/spread, and abdomen will fill up to point that pressure on her lungs will impair breathing and they will have to do ER operation, etc. Basically, if someone, because of age or other reasons, chooses not to have any surgery or any other treatment, what does the cancer do to the body and what can the medical profession do to help alleviate the suffering?

BonnieR's picture
BonnieR
Posts: 1549
Joined: Jan 2004

Dear jp, I am so sorry to hear about your mother. I am not a physician but I couldn't imagine leaving such a huge growth in my abdomen and the affect it would have both physically and mentally. I know 89 sounds old, and boy would I love to reach it, but I sit next to people in their 80's getting chemo and some do better than me. I know chemo and/or surgery isn't for everyone and I would go by both what the Drs recommend and what her heart tells her.

Why is she thinking about not doing surgery or chemo? Is she afraid or just feels like she's done enough and is ready to go. The reasons why play a huge factor into what we do. I knew a lady only 49 that just didn't like the chemo and choose not to get it the second time.

Lots of things to think about, questions to ask the Drs, and prayers. I will be praying for you and your mother. Bonnie

jphilli8
Posts: 5
Joined: Oct 2006

Thank you for taking the time to reply to me. My mom doesn't know yet. I've only told her that they found a cyst in her pelvic region. We see her internist this afternoon who should have the results of the CR125. I scheduled an appointment with the GYN tomorrow afternoon to discuss options. I don't know what/how my mother will react. But she also has a very large hernia at her naval that she's refused surgery on for more then 30 years. She's always said she's too old for surgery on the hernia. Aside from some mild heart problems, mom's never been sick in her life until now. The fear about surgery and chemo, for now, is mine. I have a good friend, a anesthesilogist, whose 43 year old sister is in the last stages of ovarian cancer after a year and a half of multiple surgeries and chemo. I know what she's gone through and I don't know if my mother could go through that, e.g. which is worse, going through the surgery which would likely include a hysterectormy as well, then chemo, or do nothing? It's a quality of life versus quantity of life issue, I guess.

jamilou's picture
jamilou
Posts: 202
Joined: Mar 2005

Hi
I am so sorry to hear of your mother's health problems. My husband's grandmother (80)who lived with us made the decision not to be treated a second time for ovarian cancer. We suspected that the cancer was back but she refused treatment and did not tell us until it was quite involved again. It was her choice not to have treatment again even though they could have helped her. The doctors treated the problems that they could with medication and kept her as comfortable as possible. She could have been treated at home but chose to go to the hospital at the end so her young grandchildren would not see her die. The doctors were able to medicate her and help her with the pain control. Nanny was a fighter so it was quite a shock to see her give up. We are not sure why she made the choice but when she did her doctors did everything they could to make it comfortable and with dignity. I hope that you and your mother are able to be at peace with whatever decision she makes. Good luck and God Bless you both.
Jami

jphilli8
Posts: 5
Joined: Oct 2006

Thank you for your reply. See my response to the first reply above, as well. It was very helpful to hear from you that your husband's 80 year old grandmother went through treatment once. It's also helpful to hear that her doctors did everything at the end to make it comfortable. I guess my own fear, as her daughter and caretaker, comes from my having sat with an aunt every day for a month, who was dying from breast cancer that had spread to her bones, she was not in a hospital, but only a nursing home and they didn't or couldn't give her enough morphine to stop the pain despite my constant pleading with them (this was back when we lived in Florida and they said they couldn't give her more morphine as it would kill her and they could be prosecuted, etc.). No matter what mom's choice is, treatment or not, I just don't want my mother to suffer and I feel powerless to do anthing and I just feel tremendously, tremendously sad because of that. I have even seriously investigated the option of moving to Oregon, which has a right to die law, to give mom that option should she choose, but being raised a staunch Catholic, even though she's not a practicing Catholic anymore, I don't think she would choose that option. Thank you again and I will update my post after we learn more from the doctors, mom is told and makes a decision.

mopar
Posts: 1954
Joined: Apr 2003

Your situation brings me to tears. This must be so difficult for all of you. As all the others, I agree that your mom has to make the best informed decision that she can. My mother developed colon cancer at age 80. She was never ill in her life, so this was a huge shock. Being an ovarian cancer surivor myself (now recently a second time!), we researched together, went to all appointments together and she made her own decisions. We didn't know where it would all take her - surgery, a port, chemo, she ended up having a stroke. But through it all she remained strong, kept the faith. But I believe, once she became bed-ridden she decided this was enough for her - no more chemo. My mother was kept comfortable, and was alert and speaking to us up to 1 day before she passed. I knew she would not be strong enough again to resume the chemo (and she had done excellent with her first treatment). She was a peace with the situation. I struggled with it. I will pray for your Mom that she will find peace with her decision, and for you that you will be able to accept whatever she decides.
Hugs, prayers, and well-wishes.
Monika

jphilli8
Posts: 5
Joined: Oct 2006

Thank you for your reply and support. We have some conflicting news/opinions we are dealing with. We went to mom's internist yesterday to get the reports on the CA125. The CA125 came back "8", i.e. well below the "35" top normal range. However, mom's internist still insists that the radiologist is adamant that mom has ovarian cancer. The GYN the internist referred us to called and cancelled the appointment and said the cyst was too large, i.e. 13.9 cm, for him to operate and referred us to a gyn/oncologist for the surgery. However, this gyn/oncologist is out of the office getting married and on his honeymoon and the earliest appointment with him is 11/17. There is only one other gyn/oncologist in Honolulu I'm told, but I'm also told that he likely won't be willing to operate on my mom as she is 89 years old. To add to this, I spoke with a good friend, an anesthesiologist in a gyn practice group, who's own sister is in the end stage of ovarian cancer after a year and a half of treatment, and when he heard mom's CA125 came back as "8", he immediately said "your mom doesn't have cancer." So, is he right???? The complex septated cyst is also thin walled, not thick which it is my understanding malignant septated cysts have thick walls. Also, my dr friend noted that the catscan report showed no evidence of ascites which normally would be present if malignant. So I don't know what to think or do at the moment, other then hope my mom's condition doesn't worsen in the next two weeks while we wait for the gyn/oncologist to return from his honeymoon.

BonnieR's picture
BonnieR
Posts: 1549
Joined: Jan 2004

Sometimes a person has a low ca125 and still has cancer. But it could be just a cyst. Nov 17 sounds far off but it'll be here soon. If it was my mom I'd wait for the gyn/onc. Good luck and God Bless

Cindy54's picture
Cindy54
Posts: 454
Joined: Aug 2006

Hello.I am sorry to hear about your Mom. I too have had a Mom with ovarian cancer at the age of 89. There is another post on here about her. When the doctor told my Mom she had cancer it was her decision about what to do. Since she was bleeding and taking Magace, this couldn't continue forever. She and her doctor decided to do the surgery. It was quite extensive. Hysterectomy, liver lobe removed, bowel resection, colostomy. Whatever looked cancerous the doctor removed as best he could. The doctor did not advise chemo for her. It is now well over a year later and Mom is still here with nothing coming back. Yes, she does have some cells floating around. But nothing has grown back. A lot depends on what your Mom's wishes are. And it is not easy to help someone through this. Mom had a lot of healing to do.And it took a lot out of her. A lot of the meds she was on had side effects. She had nightmares, as most seniors I saw, in ICU. It was not an easy thing to go through for her or for me to watch. Today she gets around a bit with a walker. But she has no pain for the first time in years.She also naps a lot. I figure she has earned it. I will send a prayer your way. I hope you find peace in the decision you make. And if I can help in any way by letting you know what Mom has gone through, please feel that you can contact me. I wish you well. Cindy

jphilli8
Posts: 5
Joined: Oct 2006

Thank you so much for taking the time to share this information with me. It helps a great deal to hear that someone else, 89 years old, has gone through this successfully and has lived another year, etc. as well as to hear what she has to deal with, physically. We are now in a bit of a delimna. See my response to the reply posted just above yours. We have some conflicting opinions to deal with right now in light of mom's CA125 coming back well within normal limits at "8" and my dr friend's opinion that mom does not have cancer versus the opinion of mom's internist and the radiologist that she does have ovarian cancer. The gyn/oncologist we are now being referred to is out of town until 11/17, so I have to decide whether, in the meantime, I should try and get in to see the only other gyn/oncologist in Honolulu, even though I've been told that he likely won't operate on my mom because he doesn't like to operate on elderly patients or on patients that he doesn't think will benefit for certain, etc.

Cindy54's picture
Cindy54
Posts: 454
Joined: Aug 2006

Is it possible your Mom has just a large no-cancerous ovarian cyst? Can the surgeon just be a gynecologist? Is there another one that you could get an opinion from? Is it possible that you could move to the states somewhere and seek medical advice here? I know your Mom must be very uncomfortable with this inside her, but maybe you need another opinion to make a better informed decision. Have you contacted the local cancer society there and told your story? Maybe someone there can steer you in a better direction. I know you hate to see your Mom in pain, but try to find some options before you both need to make a decision. One other thought...is there a specialist that takes gastroenterolgy cases? Perhaps just a person who specializes in stomach problems could help. Or a regular surgical oncologist. My Mom had a gyno who did the hysterectomy, a surgical oncologist who did the other surgery, another back up surgeon who filled in when the gyno had to go deliver a baby. Get as much info as you can and don't be frustrated by doctors who throw out age as a reason not to help her. If she is willing to do something to feel better and you are there to help her, there has to be someone to help you. Don't give up until you are comfortable with the answers you get. I wish you the very best in this. Cindy

groundeffect
Posts: 651
Joined: Mar 2003

This is a real conundrum. Of course, you should be frank with your mom about the prospects, even as confusing as they are. My father in law had colon cancer surgery five years ago, no chemo, and is 90 now. He's been in the hospital since for other reasons, and has suffered delerium at least once - normal, but very scary, so I know how that can be a deterrent.

Has anyone suggested maybe just chemo for an initial treatment? It would seem that, if it were a tumor rather than a cyst, that it would shrink-but they'd probably "have" to know it was OVCA to do that.

I think you'll probably do better to wait for the gyn/oncologist who is willing to do the surgery. I certainly wouldn't want someone who prefers better odds (i.e., younger patients) working on my mom!

When I was past my chemo, I listened to a book on tape call "How We Die" by Sherwin B. Nuland. The doctor drew on his own experiences with loved ones and folks in his practice to develop his thoughts on life and the prospect of dying, and I found it helpful in alleviating a lot of the anxiety I was having then about the future. You may find some of his observations helpful in making decisions for your mom.

I wish you both peace in whatever is decided, and hope you won't anguish over your decisions; you'll probably feel much better once they're made.

collins
Posts: 69
Joined: Oct 2006

I am very sorry to her about your mom being diagnoses with ovarian cancer or maybe not. I was just diagnosed with reocurrent ovarian cancer. My ca125 is 12 and lower and since chemo has never been over 18. A pet scan showed I had cancer and my oncologist still wanting to be certain because of low ca125 ordered a biopsi. My biopsi showed the return of the cancer. A family friend of mine who was just two month shy of 90 recently had a complete hsyorectomy (ovaries and all), had both her colon and bladder tied up. She was up and going less than two weeks following surgery. She did not have cancer but had surgery for colon cancer 4 or 5 yers ago.

Cindy54's picture
Cindy54
Posts: 454
Joined: Aug 2006

wow! It sounds like a lot of the older folks are proving to be quite an inspiration for us younger ones! And they are not just surviving they are thriving. They have a pretty decent quality of life. This gives me a lot of hope for when I reach that age. I have not had ovarian cancer or anything of that kind to deal with. Have not had any experience with chemo. But I spent nearly 7 1/2 months with my Mom in hospital and got to see what a lot of the other people went through. She did not have chemo. But it was still very eye opening. Just when Mom started getting back on her feet I ended up in the hospital with a spinal cord tumor. My legs just gave out on me. After successful surgery, it was benign, of a three inch tumor, it took me 2 months to learn how to walk again. I saw a lot of folks in rehab that were cancer patients and their strength was phenomenal. While both my Mom's experience and mine were something I would never have chosen to go through, it made me a lot stronger in my faith and in my encouragement of other people who are going through so much in their lives. Don't ever, ever give up. There is so much new stuff happening each day in the medical field. And there are so many miracles around. There is so much information on this board and at your local cancer society. And on the internet that if you take the time to look you can find someone to help you make an informed decision. Don't ever, ever give up. You never know when something you have experienced might just help another person going through the same or similiar thing.

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