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Should My Mother Have Surgery?


FrankAB

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My mother was recently diagnosed with lung cancer. A PET scan did not detect matastses. She is 69 years old, a life-long smoker and drinker, has moderate emphesema, is not ambulatory and has a host of other health problems, none terminal. She wants my opinion on whether or not she should pursue the operation. She herself seems lackluster about pursuing it.

Unfortunately my view is colored by the fact that I helped a dear friend through lung cancer 10 years ago. With my encouragement, she pursued chemotherapy, even though her diagnosis was terminal. It ruined any quality of life for her, and made her last days truly miserable. I always had the feeling that the doctors knew there was no hope, but nobody wanted to tell her that.

Now I face this with my mother. The doctors are saying surgery might be technically feasible, but it is hard for me to imagine her going through such an ordeal. I feel very guilty advising her that she might want to consider pursuing palliative treatment only, but the visions of my poor friend, who was so much younger and in vastly better health, wracked with chemotherapy side effects in her final days won't go away. Is it better for my mother to enjoy her final months (or year(s)) in as much comfort as we can give her, or should we roll the dice and go for the surgery? (In truth, I don't think that the doctors will ultimately advise surgery, and all have advised to consider non-surgical, non-definitive treatment, but none has yet come out and said "listen, don't do this to yourself. ")

Does anyone know of an elderly, very infirm person who thrived after lung surgery? What are my mother's chances?

Thank you.

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I can't help you with that decision. I do know that the best chance for a cure is surgery. But is it a cure if she isn't strong enough to withstand the surgery? I want to wish you the best in making your very hard decision. I am sure that whatever you decide to do will be for the best.

Nina

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depending on where the tumor is and how big, she may qualify for surgery by VATS . It is done with a minimally invasive surgery, ( no broken ribs etc) Small incision, and the tumor is removed by scope, home in a few days, much easier recoup. Why not ask. Donna G

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Dear Frank,

Have you been able to sit down and have a good, long, frank discussion with the doctors? My husband was diagnosed last spring and was also a lifelong smoker (had tried three times, unsuccessfully, to quit) and had just turned 75 to boot. The surgeon was very careful about determining whether he could withstand the operation -- went through a very thorough medical history and examination, pulled in a pulmonologist, talked extensively with our primary care physician but then recommended the surgery. Len was in pretty good physical shape other than the tumour -- and it turned out, after surgery, that he does have a mild case of emphysema as virtually every smoker of that duration would. He withstood the operation well and chemo following it (we're just finishing that up now).

We were told that his best chance was surgery which removed the malignancy but also found one malignant lymph node, also removed. The chemo followed and he has a fair chance of a complete cure at this point. We're considering radiation to up those chances but haven't reached that decision.

At each step of the way, however, we stopped and conferred thoroughly with whatever doctor was involved to make sure that he could go through the procedure without dire consequences. We were fortunate in our physicians -- they were all very forthcoming, frank and thorough and also very much on top of the latest information in the battle against lung cancer.

The only consequence he has suffered is continued discomfort in the rib cage area, something that is related to nerve damage during surgery. We're hoping it will eventually go away, and lots of people on this board have experienced similar things.

Again, all I can urge is that you consider EVERYTHING but discuss it all and get every bit of information you can lay your hands on before your mother makes a decision. She needs to know as much as she can -- and about the possible positive outcomes as well as the dangers.

Good luck, and I'll be thinking of you.

Ellen

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Dear Frank,

First of all, 69 yrs. is not old (I am 60). That said, I think that your role in this dilemma is that of supporting & loving son. You seem to be doing that well. Your mom's decision (whatever it is) to take or forego chemo is a tough one, but not insurmountable. She can always discontinue treatment if the side effects are too much. Her quality of life is of course hers alone to judge. What would seem to us to be innadequate and sad might be enough for her to wish to continue.

Good luck & God bless. Claire

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Frank,

As Im sure you already know, surgery is the best chance a person with Cancer can have. My dad had his surgery in June. He also is a lifelong smoker, and moderate drinker. Now, 2 months after surgery, hes starting to feel pretty good. Its been a rough 2 months, but things seem to be calming down. I think if you and your mom have the right additude about this, SHE CAN BEAT IT! I think anyone offered surgery should at least really think about it, I mean, you never know what may come out of it... my dad is cancer free right now! I hope this helps you somehow!

Jamie

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That is such a tough decision. I can't say either way. Lung Volume Reduction Surgery is done for emphysema, but I read some bad things about it. The NETT trial was for LVRS.

Get as much information as you can. All the Pros/Cons of each side.

Make sure you find a surgeon who has done the operation MANY times.

Also you might want to seek out opinions from specialists in only pallative care. Then compare the two with your mother.

This article is old though 1999

http://www.findarticles.com/p/articles/ ... i_58614574

http://www.smw.ch/pdf200x/2003/01/smw-10021.PDF

http://www.respiratoryreviews.com/jul03 ... _NETT.html

Good luck

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That is such a tough decision. I can't say either way. Lung Volume Reduction Surgery is done for emphysema, but I read some bad things about it. The NETT trial was for LVRS.

Get as much information as you can. All the Pros/Cons of each side.

Make sure you find a surgeon who has done the operation MANY times.

Also you might want to seek out opinions from specialists in only pallative care. Then compare the two with your mother.

This article is old though 1999

http://www.findarticles.com/p/articles/ ... i_58614574

http://www.smw.ch/pdf200x/2003/01/smw-10021.PDF

http://www.respiratoryreviews.com/jul03 ... _NETT.html

Good luck

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That is such a tough decision. I can't say either way. Lung Volume Reduction Surgery is done for emphysema, but I read some bad things about it. The NETT trial was for LVRS.

Get as much information as you can. All the Pros/Cons of each side.

Make sure you find a surgeon who has done the operation MANY times.

Also you might want to seek out opinions from specialists in only pallative care. Then compare the two with your mother.

This article is old though 1999

http://www.findarticles.com/p/articles/ ... i_58614574

http://www.smw.ch/pdf200x/2003/01/smw-10021.PDF

http://www.respiratoryreviews.com/jul03 ... _NETT.html

Good luck

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That is such a tough decision. I can't say either way. Lung Volume Reduction Surgery is done for emphysema, but I read some bad things about it. The NETT trial was for LVRS.

Get as much information as you can. All the Pros/Cons of each side.

Make sure you find a surgeon who has done the operation MANY times.

Also you might want to seek out opinions from specialists in only pallative care. Then compare the two with your mother.

This article is old though 1999

http://www.findarticles.com/p/articles/ ... i_58614574

http://www.smw.ch/pdf200x/2003/01/smw-10021.PDF

http://www.respiratoryreviews.com/jul03 ... _NETT.html

Good luck

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I first want to welcome you to this board. We are glad you found us and I hope we can help you deal with all this. I would like to point out to you that the chemotherapy of yesterday is not the chemotherapy of today. It can be bad, yes, but many find they can handle it quite well. They do lots of premedication to keep the side effects down. Your Mom has to decide how important it is for her to fight and no one else can make that decision. Once the decision is made, it is the right one for her and she should be supoorted in it. Just make it with todays facts, not yesterdays fears.

Blessings

Betty

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