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And possible breast cancer.

She's the only grama I have left - and while we are not blood, I have known her most of my life.

I dont know what one does for a 92 year old. Do they even give the option to treat?

I remember a woman with lung cancer on my other grama's ward who was almost 90 fighting lung cancer like a champ - chemo, radiation, the whole 9 yards at almost 90.

Not really sure what else to say. She is so active, so healthy, if you were to look at her she looks like maybe 80's....but this, this is scary.

(((Undefinabl3 & grandma)))

(((Undefinabl3)))

When my grandma was 89 she was diagnosed with breast cancer, they offered her a double mastectomy but she declined. She did live a relatively healthy rest of her life for 4 more years.

(((((Undefinabl3 & grama)))))

Keeping her in my thoughts.

Thanks....Ironically, I work in the same building as a very well funded Breast Cancer program (think handbag mogal)....

I have in my contacts 5 of the top breast cancer doctors in at least the midwest.

Looking up the research for the older patient is sad honestly. Most women her age choose to do nothing, so there is very little research for treatment information on women 70 and older.

We knew that we only had a few years. We dont live forever, and lets face it 92 is nothing to sneeze about.

But really, she made it this far, couldn't she have gotten to go out peacefully in her sleep...shit she's earned that right.

((((undef))))

Its still possible at this point? what would she want to do?

My grandma was diagnosed in her late 80's I believe and had the radiation treatments for I believe 6 weeks and I forget what else now. But she is a survivor and will 100 this January 17.

What would you want to do if you were facing the same decision? What does SHE want to do?

Ultimately it is up to each individual how they want the end of their life to go. Or at least it should be.

I would look at the treatment options, and the odds of quality of life with treatment and make a decision from there.

And she could still die peacefully - with pain management it doesn't have to be a horrible end if she chooses not to treat.

Sending strength and peace.

NL

I know how sad this is. My mother passed away from cancer at 84 (almost 2 years ago). Her cancer was inoperable, and she chose to not treat with radiation/chemo. Diagnosed in July, lost her in October. For the first 2 months she said she didn't even feel like she had cancer. Then she went downhill, but the pain, for the most part, was not too bad. I turned my family room into a bedroom for her, and fortunately we had access to 12 hours/day care for about the last month.

She was comfortable, watched tv, gave my daughter her history. My daughter published a book (online, not for stores) for our relatives...hard copies were ordered.

Let your grandmother decide what she wants to do, or not do. Support her no matter what her decision. And, I know my mother enjoyed talking with my daughter hour after hour about her life. It filled many of her days.

She was at peace with the knowledge that she was going to her maker. I know her faith made it a lot easier on her.

No matter what she chooses, this is a good time to get her life stories from her.

I'm very sorry about your grandmother. 92 is a good long life. Remember that.

[This message edited by JanetS at 5:28 PM, August 21st (Wednesday)]

I'm glad that you have such good doctors to take advice from. I have a feeling that it will be more of what she wants, than anything else. But for what it's worth, my 90 year old Aunt is healing up from jaw cancer surgery and is expected to do very well. She's very healthy and active hopefully your grandmother's health will help her no matter her choice as well. (((hugs)))

What would you want to do if you were facing the same decision? What does SHE want to do?

Personally, i would have never gone to get the biopsy in the first place...what's the point right?

I am just really hoping that my step dad doesnt push her into anything that she really doesnt want to do.

I lost both of my blood gramams 3 weeks apart from each other in 2007. I know about cancer.

I guess i am just pissed off at God, she's lived so well, and had a good life, and then poof...possible cancer. We wont know until next week.

I would look at the treatment options, and the odds of quality of life with treatment and make a decision from there

And that is the get. There is not a research base for women over 80 because many will choose not to do anything about it.

And in all reality, i can see her having surgury to remove the tumor, but aside from that, I dont see her agreeing to anything else.

But then that's it....no more grama's of any kind....Why does the world get lonelier the older you get?

(((huge hugs)))

I'm glad you have some excellent docs you can talk to about this, if need be.

Given her age, if she is healthy, she may opt to do a "lumpectomy" and nothing else. If she has other health risks, such as heart disase, a mastectomy is a much bigger surgery and needs general anesthesia, etc. A mastectomy won't really change her outcome either, given her age. A lumpectomy they can usually do under sedation. She won't need a lymph node biopsy at her age, so a lumpectomy would be a relatively small procedure.

(((hugs)))

[This message edited by hill at 7:28 AM, August 23rd (Friday)]

Suprisingly, she is fairly open to doing things within reason. I suspect that she would be ok with a lumpectomy, rather then a mastectomy.

The downside is that she already has an issue with anemia, and chemo carries the possibility of being very hard for her to handle.

The research doctor that I spoke with says that there is virtually no study subjects her age to even speculate on. Generally women that age just feel like they have lived a good full life, and choose not to treat. Because of that, the research data pretty much peters of in the late 70's very early 80's.

Not to say that there are not ladies out there that do, but there have been no studies done on advanced age geriatric population.

I am still fighing my feelings on this so much though. Having my other 2 grama's go from cancer, albeit lung cancer, this puts me back to that horrible crazy time. On the other, i am so glad that I am close enough to help, be there for her, and still be able to get good time.

You guys are awesome though - always there with a hug and words of strength.

She's so lucky to have a wonderful, caring granddaughter like you.

Its malignant

(((((((undef))))))))

I'm so sorry. I know this is not the news you were wanting.

She's thinking about doing treatment since apparently you can take pills now. I tried to explain to her that just because its a pill and not a port that the side effects are horrible. But how do you squash someone's hope like that?

They go on wed. to discuss options and what other tests they need to do.

Any chance you can go along with them to the appointment since this is kinda your gig?

The really need to have the quality/quantity discussion. Seriously the hard questions need to be asked. If nohthing is done, what is the possible outcome? Meaning how long before the breast cancer gets her? There multiple types of breast cancer, and some are slow growing. You need to rule out that it's not one of those. If it is, then it may be something she would pass with, not from. Not unlike prostate cancer in older men.

The chronic anemia is common the octogenerian patient population and beyond. But she probably needs a work up to determine why prior to starting any type of aggressive treatment.

((((and strength ))))

I wish i could, but she's not open to having everyone there. My mom and my step dad are going - I would love to pass on some questions to my mom though.

Wed. will tell us more about what stage it is in, and get her scheduled for a PET scan to see if it has already spread. Chances are high that it is in her lymph nodes by her breast, and possibly the ones in her lower back (has been having unexplained pain there recently).

Just by reading up on it and getting the information she is at least at Stage 2B, and if they find anything on the PET Scan anywhere else, she automatically goes to stage 4.

Stage 2 carries with it Lumpectomy, radiation therapy, and chemo.

Stage 4, is just not a happy time at all....

The doctor seems to think that since Grama is in good health for her age, that she could withstand the treatments.

I think its a load of crap. I have read up on some of these oral treatments and there's just the same issues as with the IV.

(((undef)))

((((Undef))))

Remeber these Oncologists, and surgeons are focused on heal get well, heal, get well. Sometime lack the ability to look at things in a realistic view. I think the questions of quality vs quantity are valid, and very important to ask.

If she has it in her lymph nodes its stage 4. You are right that is not a great place as far as treatment goes. Please encourage your mom to ask about Palliative medicine vs. surgery and chemo. Radiation therapy, and lumpectomy is not that terrible. But I definately would be concerned about doing anything more than that. Even if she is still strong and independent, she is 92. That is 92 years of wear and tear on her heart, her lungs, her liver, her muscles, all of it.

Unfortunatley in my 21+ years of doing this nursing thing I have seen more than my fair number of Dr's that just don't have the balls to be honest with people. Which I still don't get. Why would you cheat someone out of quality with the time they have left ?!?!