My mom was recently diagnosed

[Guest mqh123]

My mom's 77. Two years ago they found a small mass on her lung during a CAT scan, but couldn't definitively call it cancer. They said "likely," but she refused any sort of biopsy or invasive procedure. Last week, another CAT scan showed the thing had grown considerably and now they say "yes, lung cancer."

My mom has had a hard life, physically - she's very frail. She's said repeatedly that she wants no treatment, she just wants to be kept comfortable. She's had a ton of other physical problems - she's scared of dying, but she also see this as a bit of a relief and release. Mentally, she's all present, but her body seems to have checked out years ago, so I can't blame her, really.

So I'm going to talk to her doctor tomorrow. I don't even know the jargon yet. What sorts of questions should I be asking him about what she has, how long she has, what the progression will look like? Is she giving up too easily? Do we trust her judgement or do we try to talk her into some sort of treatment?

[recce101]

Welcome to the LCSC!

You've posed some difficult questions. There's no way anyone can tell you what you SHOULD do in this situation, but I can give you some of my thoughts and you can use your good judgment (which your post indicates you certainly have) to pick and choose or discard any of my ideas as you see fit.

First, in speaking to the doctor, I would not ask "how long she has" in those terms. He doesn't know, and any number he gave would be a guess based on the average/median survival of others with a similar diagnosis in the past. If you really need some kind of time reference, you might ask for a general range of months/years based on what the doctor knows of her situation, but don't place too much weight on it.

Getting a meaningful prognosis for your mom is further complicated if she continues to refuse a biopsy, and though lung cancer is highly suspected because of the CT scan changes, neither the specific type of cancer (small-cell vs. non-small-cell vs. some variation/combination) nor the best treatment for it (which varies with the type) can be definitely determined without a tissue sample.

I completely understand your mom's point of view. Though I was in relatively good general health when I received my diagnosis at age 71 and have been on treatment for 16 months with good results so far, if I'd been frail with lots of other physical problems I'm sure I would have felt exactly like your mom. I would have felt perfectly capable of making my own decision about treatment and would have appreciated factual information but not any pressure to accept treatment that would reduce my quality of life in whatever time I had remaining. On the other hand, some people want to extend life pretty much at all costs, and their decision must be respected too.

...she's scared of dying, but she also sees this as a bit of a relief and release.

This gets very personal, and it involves religious beliefs and/or philosophical concepts that can't be adequately discussed in a forum like this. Fear of death is essentially fear of the unknown, and people deal with it in many different ways. Everyone knows it's inevitable, but some bring themselves to peaceful acceptance sooner than others. A few even come to look upon it as a new adventure. I vividly remember the account of one of our members who fought his cancer valiantly, and near the end was hospitalized but continued to decline, then shortly before he passed opened his eyes and exclaimed, "This is going to be great!" From your quote, I get the feeling that your mom is resolving her fear in a positive way. Blessings and Aloha,

Ned

[recce101]

Please let us know what your mom's doc says when you see him today. Aloha,

Ned

[Guest mqh123]

My brother talked to my mom's doctor. What he said was that there wasn't much change between her first and second scans (two years ago and one year ago), but there was a big change between the second scan and the one last week. But we don't have any actual numbers, just these sort of vague "big" and "small" descriptions. And because she doesn't want any further diagnostics, he says he can't tell anything more about what's going on. Just that there's something growing in her lung.

So maybe there's no more to know at this point. Or, maybe there's just not much point to pushing for more knowledge. I mean, I guess I'd feel differently if he said "tiny" or "massive." But beyond that, there's not much for us to *do*, except get ready, whatever that means.

[recce101]

Thanks for the update. I know this is very hard for you, and there's not much you can do if your mom will not agree to a biopsy. But try not to get too far ahead of yourself in imagining what will happen down the road -- it's possible the tumor could stop growing as it apparently did between the first two scans, and spontaneous remissions, while rare, are not unheard of.

On the other hand (and please forgive me if I'm going beyond what you want to consider right now), if your mom's cancer does continue to progress, you should know that precisely targeted radiation can be VERY effective in reducing or eliminating pain, especially from bone metastases should they develop. Palliative radiation doesn't treat or slow down the cancer, but it can provide a great deal of comfort (quality of life) and reduce the need for pain medication.

Many of our members have had first-hand experience caring for loved ones in situations similar to yours, while I have not, so I'm going to take a back seat now so you can communicate on your own schedule with those who truly know. My very best wishes and Aloha to you and your mom,

Ned

[Guest mqh123]

Wow - thanks. I clearly have an awful lot to learn. I've never even heard of "palliative radiation."

My mom's sister died of cancer when she was in her 40's - that's 30 years ago, and it just occurred to me that my mom is probably viewing the world of treatment options and difficulties through some really old glasses. Lots to learn - thanks.

Matthew