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[DebJ]

Hi I am new here. The Pulmonologist told me that my sister's 2.5cm  lung nodule is highly likely cancer. She had a very aggressive cancer (can't remember the name of if) & had to have a total hysterectomy in 2019. The type she had then would most likely reoccur within 5 years. She is on the fence about a biopsy, I am trying to convince her have it done, if for no other reason to help me plan things since she lives with me & I will be her main caregiver for as long as I am able. I am 70, she is 60 with multiple health issues including Hypo-Thyroid & Diabetes.  Any input would be helpful, good bad or indifferent. I would like to know what I am up against - She says no treatment of any kind. Thanks in advance 

[RJN]

I am very sorry to hear about your sister’s situation. I can understand if she has been through harsh treatment before that she would be wary of going through it again.

One important thing to note is that in the past 5-10 years, there are a lot of new treatment types which are for most people much less harsh than the traditional ones. I am on immunotherapy, and other than some joint niggles I have had no real side effects. Some people get other side effects, but generally it is an easier ride and is only a short infusion every three weeks. The same goes for targeted treatments which are mainly in daily tablet form.

Just my penny’s worth - hope for the best, Rikke

[DebJ]

Thanks so much for responding. I am happy that treatment has been kind & appears to be working for you. May it continue. Sister says NO treatment & I respect that & will not try to change her mind.    She is tired, just simply tired of the pain, both physically & emotionally & after doing a bit of research I think this could have metastasized to her brain. Her gait is that of an ill/frail 80-year-old, both short & long term memory are bad, When she is thinking/concentrating she has the look of a mentally challenged person or like she is in a stupor. I am so afraid for what she will be going through (& afraid I am not up for the challenge with my age & my own health issues) This is not about me, but it is important to me to be the main care giver as long as I can do it well. I know she is depending on me, with her help I took care of both our parents & eldest sister during their last days. There is an ol country song "She Needs Someone To Hold Her When She Cries" That is how I feel right now & will until I have accepted all of this. I try to hide my fear & pain from her, though we have talked & cried together about all of it. I haven't mentioned the possible brain cancer to her but I am sure it has crossed her mind.

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[LouT]

Deb,

It sounds as if your sister has surely had a difficult road.  You raise a couple of important points and I'll try to address what I can here.  First is the biopsy; that is really the definitive test to determine if the growth is a malignancy or not.  Without the knowledge gleaned from that test (i.e., type of cancer, biomarkers, small cell vs. non-small cell, etc.) there is little that anyone can do if this is cancer and progress outside of palliative and/or hospice care.  Next, I want to reinforce what Rikke told you about treatments coming a long way.  But, that doesn't guarantee no side effects nor does it guarantee success against the type of cancer she may have.  Finally, if she is refusing all testing and treatment options (and I appreciate that is her choice to make) then you need to at least get the biopsy (if at all possible) to determine what she will be dealing with and then arrange for the appropriate level of care for her (palliative or hospice) to make her days as comfortable and pain-free as possible.  I sometimes worry that some folks look at the side-effects of treatment and believe that just letting the disease progress will be easier (something I myself have considered).  But the reality is that it may or may not be.  

If your sister is suffering from clinical depression that may be affecting her mental attitude toward treatment as well.  She might benefit from seeing a professional and perhaps some antidepressant medication.  I wish there was more I could tell you.  If she does decided to accept the diagnostic process and treatment we have a lot of information and experience to share with you for her benefit.  My prayers are with you both.

Lou

[DebJ]

Thank you so much!! This morning she has finally agreed to the biopsy (Thank you Jesus) I agree it will be most helpful to know for sure (though my instincts tell me it is, along with the Dr. saying it is highly likely) Her Chemo from the other cancer was not bad, but she said back then even that she wished she hadn't taken it & never would again so it isn't even an option with her.  She is on an Anti depressant but appears to need something more or stronger, I did mention this to her Nurse Ppractioner to no avail. 

In November she came from out of state to live with me, after being homeless, having serious health issues due to the Diabetes & Thyroid issues, not taking care of herself, plus having abused Meth for an extended period. 😪 She had spent the better part of the previous 3 months in hospitals both Medical & Psychiatric. At that time the nodule was found. When she came here, she had been clean from the meth for an undetermined amount of time IE:1, 2, 3 months? She is still 'clean'. I found an agency that deals with addicts & can provide all medical & mental health as needed for her. They are just very slow & it has kept me hopping to keep after them to get the much needed testing done. I will be switching her insurance & searching for a regular doctor or clinic ASAP, plus getting a POA & other needed papers in order. Most or maybe all of her depression stems from childhood/teen abuse of all kinds from our mom & other people that sis was exposed to. I am trying to help her understand her worth & the defects were not with her but with her abusers. I am rambling & don't mean to, just wanted to give you some background on her. I appreciate all comments, but - Please don't condemn her for her drug abuse. I  don't agree with it, but I feel I understand it. 

Thank You

[Justin1970]

Hi deb 

This is a very difficult time and your sister is in a very dark place that most of us have found ourselves in,I nearly gave up and refused all treatment plans myself but with the help and support of my family and antidepressants i did get through it and now have a much better attitude towards everything so hopefully this will be the same for your sister and you, try and stay strong and positive and I wish you all the best 

Take care Justin x 

[DebJ]

Thank you Justin. I promised her if she would have the biopsy done that I would not try to change her mind about treatment & would support her wishes. She says the worst thing about all of this is know she is hurting people. (As if this is her fault) As I believe I have said before, the previous cancer has a high rate of it coming back within 5 years & it has been 2 years & 9 months. Also her DNA shows she is prone to soft tissue cancer. She has a lump in her arm pit (Lymph node?) Has lost 7.1 lb in 3 months in spite of her continual junk food/sugar eating, a lot of sleeping & very little exercise other than what one would do in a small apartment. 

Happy to know you had a strong support system, my sister does also & I kno2w that helps. Her 2 sons are out of state, but keep in touch pretty well by phone, but my daughter & her adult kids are ready to do what they can at any time & live pretty close. 

[Justin1970]

You sound like a very positive and supportive family and that's what your sister needs and it is great that she has all of you around her, I hope everything goes well and wish you all the best 

Take care Justin x 

[DebJ]

50 minutes ago, Justin1970 said:

 

Thank you so much Justin. I have great faith & that helps also. 

[Karen_L]

You are a good and wise sister. Although it may be difficult for you to honor her wishes for no treatment, I echo what Lou said about planning for palliative care or hospice. I'm so glad she is off the streets and in recovery. 

Karen

[DebJ]

Thank you, believer me so am I! Getting things lined up for her is how I finally convinced her to have the biopsy done, have to have a diagnosis in order to line up the help. Luckily we have wonderful programs for medical help in our area for both seniors & disabled. As soon as I hear from the doctor's office as to when this is scheduled (I know he wanted it stat) I will begin making calls for what will be needed.  

[Justin1970]

Hi deb 

Hope everything is moving forward in a good way,how are you all doing and coping, all the best and take care Justin x 

[DebJ]

Thank you for thinking of us! 🙂 Biopsy is scheduled for the 25th. (Due to Easter none are being scheduled for next week for some reason) I am accepting things a bit better but am now even more concerned about a lump in her arm pit. Of course also I pay more attention to her random chest & abdominal pains, everything makes me wonder now. 

She is having a hard time of course, very worried about the pain she is causing her loved ones, in spite of me telling her it is not her fault & we will all handle this. Her main concern is her 2 adult sons (who btw have not called since she told them on Saturday that it is highly likely - grr)  They live out of state. I have asked for an increase in her Anti-depressant & luckily she has agreed to some counseling. I want her to live until ...

She/we are looking forward to Easter with my daughter, grandkids & (12) great grandkids.  Her mind will be occupied with them for a while & will be physically exhausted not just mentally tired. I pray this brings her a more restful sleep that night. She is sleeping most of the time now to escape, thought I did get her to watch a comedy with me yesterday. 

Again, thanks for asking. 

Happy Easter to you & yours

[Justin1970]

The time with you and the family will definitely help her,I know how hard it is for her mentally and what the family goes through but try and enjoy the Easter break and time together, thank you I am spending some time with the family this weekend so should take my mind off things for a bit.

All the best Take care Justin x 

[Justin1970]

Hi deb

I just wondered how you and your sister were doing, I hope everything is going well all the best Take care Justin x 

[DebJ]

Thank you for asking. We are hanging in there, still waiting on answers. The biopsy was inconclusive, apparently they didn't get enough tissue. Another CT is scheduled for June 20, and he said a needle biopsy at that time. When the hospital called to confirm the CT they have no information on a needle biopsy, but a possible resection. Well, there will be no resection per my sister, but even if she would agree to it, I would want a major discussion as to what all it would entail, recouperation time etc. I am lost & pretty frustrated at this point. I will try to have a talk with the Dr. to find out exactly what his plans are. Sis is showing no symptoms & is upbeat & positive. Feels she will beat this in spite of saying no surgeries, & no Chemo.  

[Justin1970]

Goodluck with everything I hope you get some good results take care Justin x