Mom Who Just Turned 88 Diagnosed with Breast Cancer

DonnaLee925

Hello - I'm new to this community and my Mother who just turned 88-years old this past weekend was recently diagnosed with Stage 3 breast cancer - triple negative - the docs said it was a fast-growing cancer and it is close to the surface of the breast - you can actually feel it. She has gone through various tests and other than this she's in great health - no meds. There are some spots in her lymph nodes - though the docs are recommending low-dose chemo every 2-weeks for 3-months and then a PET Scan and then either a lumpectomy or mastectomy. I am curious what 'low-dose' chemo means - chemo is chemo right? I am wanting our siblings to understand what we are up against as she starts treatment and I'm sure she will need daily care - unfortunately right now she lives alone but we're working to get her daily care and we will be there to support as well. Thank you.

Moderators

Hi Donna, We are sorry that you haven't received any response yet to your question. You might also try posting in the Caregivers Forum. Here is a link to information on our main site about Second Opinions. We include it here only because it mentions some comprehensive cancer centers along with a toll free number of the Cancer Information Service for further questions. You might inquire as to whether any practices in your geographic area have Senior Adult Oncology Programs. There may be additional information for you, your mom and your siblings about low dose treatment for senior adults and other information that might be helpful as you begin to support her with her therapy. Good luck and keep us posted. The Mods

Hopeful82014

DonnaLee, I'm sorry about your mom's diagnosis. I'm sure it's a blow.

I would suggest that you get very,very specific info from her doctors, as well as copies of every test result, etc. Without that, you're going to be flailing in the dark to help her with some tough decisions.

I'm not sure what was meant by 'low-dose' chemo but it could have been CMF, which is much less harsh and generally better tolerated than most of the others. However, CMF is usually once every 3 weeks for 6 rounds, as I recall.

In your shoes I would insist on more specific treatment plans from her doctors. With triple negative, stage III cancer she will want to get started on treatment pretty quickly so they should provide as much detailed information as she needs, as quickly as possible. Good luck to all of you.

I hope someone else with more knowledge on this issue will chime in quickly. In the meantime, why not call her doctor and ask for the name of the regimen s/he's recommending?

ElaineTherese

Hi!

I had "dose dense" Adriamycin-Cytoxan which meant infusions every two weeks. Others with the same chemo regimen had infusions every three weeks -- maybe that's low dose? Hopeful might be right, too. It could be that your Mom's chemo regimen was chosen because it is better tolerated. I also agree with Hopeful that you can always call and ask the doctor. Good luck to you and your Mom!

muska

Hi Donna, your mom is 88 and any chemo might be hard at this age. There is no way for us to guess what type of chemo your mom's docs are planning but whatever it is a second opinion might be helpful.

Adriamycin-Cytoxan combination ElaineTherese mentioned, is a rather hard treatment for someone who is 88 years old, I doubt it was recommended. I had four infusions of AC every three weeks when I was 54 and I don't think this is something I would easily recommend to an 88 year old woman no matter what physical shape she is in. I had a hard time going up a flight of stairs and required blood transfusion before the last cycle.

NoUGo-CA

Hi DonnaLee, your mother is very lucky to have the support of someone like you that is reaching out to the BCO community for help. 

My mother was also diagnosed with breast cancer in her late 80's.  Low dose chemo is chemo at a reduced dose.  Probably to minimize the side effects (SE) that she will experience.  In my mother's case they were concerned with quality of life and how strong her body was (even though relatively healthy for her age) to manage the SEs of chemo treatment. It sounds harsh but at this stage in life there needs to be thought of what the purpose of treatment is.  Can the cancer be managed and treated keeping her relatively comfortable with a conservative approach  to keep her quality of life vs. aggressive treatment with possible long-term or permanent side-effects to get rid of the cancer and treat to prevent reoccurrence many years latter?  It is a different thought process and of course depends on your mother's specifics.

Mom decided on a mastectomy and that ended up being easier on her physically then the biopsy was. She didn't opt for reconstruction and is doing fine with her prosthetic.  She celebrated her 91st birthday last September.

My best to your mom and you and your siblings as you support her through this diagnosis.

Vicki

SpecialK

donnalee - so sorry to hear your mom is facing this at 88, but glad she has a caring family to help her. I would recommend that you ask your mom to sign documentation at her surgery and oncology offices that authorizes them to share information directly with you. That way you can call and ask questions of this type and they can readily discuss with you. All chemo is not created equal, some drugs are more harsh than others, and some dosing schedules cause more side effects than others. It is not out of the realm of possibility for chemo to be used, and well tolerated, in someone your mom's age, but I would hope your mom's oncologist takes her age and general health into consideration when deciding on a regimen. I would think CMF would be a candidate as it is thought to be milder but effective, and seeing a resurgence in use particularly for TN breast cancer. My dad did taxane based chemo at 82, twice, separated by a six month interval, and did very well. Wishing you both the best.

Hopeful82014

Thanks for bringing up the need for releases, SK. That had completely slipped my mind. (SMH)

Denise-G

Wanted to give you some encouragement.  My mom was diagnosed with Stage 1 breast cancer at age 80, so she did not have to do chemo.  I met two people in chemo that I always remember.  One man was 85.  I saw him all the time and he did far better than I did!  Also, there was a woman who was 90 getting chemo for breast cancer.  She was an inspiration to everyone!!

Sending my best to you and your family.

meghar

I do not know about chemo but I wanted to share with you that my mom diagnosed at age 86 with Stage 4 breast cancer in 2013, turned 90 years old in November. She just had a few scans and the cancer remains metastasized only to her bones. She takes Tylenol mostly for pain, and is doing well. I just wanted to give positive inspiration to any members who are in their older years, even the 90's, to say that age need not be a barrier to getting good treatment. My mom was on a recumbent bicycle today doing some physical therapy.

Hopeful82014

That's wonderful to hear, Meghar. Good for her and thanks to you for sharing that encouraging news. Best to both of you.

gracie22

The article linked below generally describes concerns with using chemo on the elderly, and the last para includes a link to a survey done for elderly patients to assess their chances of getting through it successfully. Your docs have likely already done such an assessment, but check and make sure. Chemo is usually recommended for TNBC, but age does matter quite a bit. Also look at the chemo benefit calculator at http://lifemath.net/cancer/breastcancer/outcome/index.php to get a general idea of the statistical benefit of chemo at her age (understand that you don't have the exact tumor size or node status yet, so not sure if helpful, but may serve as a general guide now if you can get estimates from her docs.)

https://www.scientificamerican.com/article/soh-survey-predicts-tolerance-to-chemotherapy-for-older-patients/

DonnaLee925

Thank you for your replies. Mom's first chemo went ok. The second one 'won.' She had an extremely hard time - nausea, very tired. We met with the oncologist this week and requested they lower the dose of the chemo or she won't do it anymore. The thing that surprises us most is chemo fog - her memory was getting bad but now it's terrible. She didn't even remember she was so sick one day. I think we will reassess and may go the surgery route - we will have to decide. We don't want her to be miserable. It has spread a little bit in the lymph nodes. Thank you for your kind words - articles etc. it's a rough road

gracie22

I have read that chemo can have more severe cognitive effects on the elderly, particularly if they had any memory issues or early dementia prior to treatment. My mom recently went through this same calculus when diagnosed with stage 3 uterine cancer this year at 82. She ultimately decided not to do the chemo; the stats for it just did not seem to warrant all the side effects. She also had a couple of preexisting conditions including peripheral neuropathy which likely would have been worsened by the recommended regimen. There are no easy choices with this at any point in life, but the decisions are especially difficult with the elderly. You are doing the right thing in researching and getting the perspective of people who have actually been there. The oncs are understandably focused on eradicating the cancer; it is up to the patient and their families to research what the realities of treatment side effects are and make the more difficult and nuanced decisions regarding quality of life. Younger people have a longer timeline to recover from chemo and rads; with the elderly that is not the case.

mustlovepoodles

Chemo brain is a real thing. I am 60 yrs old, 1yr post-final chemo, and i struggle with short term memory loss and concentration issues every day. It is so maddening. I know what I want to say, but I can't call up the word. DH reminds me of things that I did or didn't do but I have no recollection. I asked my MO about it and she said it could easily go on 1-2 years. Some days I feel like I have mild dementia.

Myldy

I am 9 yrs out from Stage 3A breast cancer diagnosed 2-2008 with double mastectomies, no reconstruction. I still have chemo brain/ problems focusing along with lethargy. But glad to be cancer free and alive thus far. I have learned to live with not finding my words daily, and forgetting why I go into a room. I am 64 now and doing pretty darned good...I wish I could say that the fog goes away but for me it didn't. Lymphedema in 3 extremities that needs attending to each day and neuropathy in both feet. Positive thinking is your most affective weapon for cancer and its sides effects. There isn't anything else you can do except wallow in despair....please always think positive. I wish your Mom the very best and its a big decision for all of you, but ultimately hers. Good luck and my prayers are with you all.

DonnaLee925

Hello - just a quick question .... my 88 year old Mom is going to have surgery in about a month - doctors thought she could handle surgery (heart good, etc.). They are doing a mastectomy on her left breast and some lymph areas where they found cancer. She went through about 4-5 rounds of chemo and this is the recommendation the doctors are saying next. I'm super nervous about this - have other folks who are in their 80 had a mastectomy? She has I think it's called Triple Negative breast cancer. And the tumor is close to the skin - they feel surgery is the best course of action. The other alternative well.... Thoughts on this - are we crazy?! Mom seems to want to move forward with it. I am just wondering what post-surgery care is about - she lives alone but will have plenty of family there during the day. Thanks.

gracie22

Donna, to be honest, I am surprised they recommended chemo for someone her age, and would be more concerned with that than the surgery. She evidently made it through though, so she can probably deal with the surgery ok. My grandmother in law had a mast and lymph node removal (no chemo) in her early eighties. She got through the surgery fine, but had lymphedema for the next couple of years and died of unrelated causes a couple of years after surgery. Typically, the fewer nodes they remove the less likely lymphedema is so talk to the docs about what the plan is there, and ask them about the likelihood of lymphedema. They tend to minimize it (and can't predict it beyond confirming that the more nodes removed, the more likely it is) but get it on their radar as a concern as it really impacts your Iife, especially an older person. If she is physically cleared for the surgery by her docs and she wants to go ahead, then that's what you should do. She will need help post surgery of course, possibly for several weeks depending on how she does. There will be drains post surgery that need to be emptied and records kept of the amount of fluid so docs can judge how she is healing. Some people have drains for as little as a week, others have them for several weeks depending on the amount of fluid. She will need to sleep on her back and elevated. I used a big, square, firm couch cushion behind me in the weeks after a double mast. She will have some limited arm movement, but should not have any issues with toileting, eating, drinking. She will want to take it easy with the mast side arm, not lift it above shoulder height or lift anything that weighs more that a pound or two. Showering is a challenge as you need to keep the surgery area and drain area dry. A hand held shower and help showering and washing her hair will be needed at least until the drains are out. I did not have a lot of pain, but kept ahead of it with Percocet for about 2 weeks post surgery. It is important to stay ahead of the pain, and not wait until it gets bad to use pain relievers, but lots of women have very little pain post mast (I had reconstruction which adds a lot of discomfort.) Lots of sleeping and relaxing, but a little bit of walking every day to avoid blood clots. The docs will give you post surgery instructions. It sounds as if she is a very robust person and should do fine.

DonnaLee925

Gracie - thanks for your honest feedback. It's all very nerve wracking ... appreciate your comments.