80 yr old mom with dementia and bc

I have had radiation treatment and I had a Mom with dementia but fortunately she did not have breast cancer. 

For radiation treatment she has to be able to stay completely still for repeated treatments. If her  dementia is advanced or even not so advanced she may not be able to understand or do what she has to do.  It depends on the stage of her disease and of her dementia but you should have frank and specific discussions with each of the oncologists (surgical, radiation, medical) about the best course of action. 

Do you or anyone else have a health care power of attorney for her or does she have a living will?  If so, talking to her attorney can also help.

nblj, I am so sorry that you have to go through this with your mom.  It is difficult to have a parent struggling with dementia, and the bc diagnosis on top of it adds to the stress.  You didn't say how advanced your mom's dementia is, and I think that you need to take this into account when making any decisions about her treatment.  Is she able to understand what treatment means, and is she able to cope with making decisions about her health care?

My mother was 83 when her bc was found, her lump was noticed by a care aide at the nursing home where we had moved her just a month previous.  She had full blown Alzheimer's, and although up to the time where she needed more care, she was highly functional, I don't think that she had the mental capacity to recognize that she had a breast lump.  She was diagnosed at Stage IV, with bone mets.  The decision was made, by everyone involved in her care, including the family, that the cancer should not be treated.  This was a difficult decision, since the first instinct is to try to treat the disease, but she already had a terminal condition, and it was felt that surgery, and/or chemo/rads would be more than she would have been able to process and deal with.  She did not have the ability to realize what was happening, and at the time it was felt that the treatment was worse than the disease.  She was treated palliatively, and the nursing home staff was wonderful in recognizing when her pain meds needed to be increased, so she rarely felt any discomfort.  She passed away after about 18 months.  Although we were all saddened to lose our mother, we were relieved that she left us before the Alzheimers took her away from us completely, she was still able to recognize some of us.  We felt that the wasting away of her brain was more tragic, and ultimately would have been more difficult for us to watch, than the cancer taking her.  By choosing not to treat the bc, we felt that the qol in her last year was better than it would have been had the opposite decision been made. 

Whatever you eventually decide, I wish you strength and courage.

I am sorry that your mom has BC and you are facing difficult treatment decisions.

My mother is 81 and has dementia - probably early stage 4.  She still knows who everyone is, but can't remember what she had for breakfast.    I am currently undergoing Mammosite rads and it's a fairly complex process even though it's only for 5 days.  I don't think my mom would be able to do it because she would have difficulty understanding why she has to stay still for 10 minutes or more.  And she certainly wouldn't understand all of the issues around the catheter. 

If it were my mom, I'd agree to a lumpectomy, think long and hard about node biopsy due to risk of lymphedema, and recognize that just having general anesthesia is going to take its toll on her mental function.  A mastectomy usually takes away the need for rads and might provide a better outcome, even though it's a "bigger" surgery.  But today's methods make it not quite so bad and would provide the equivalent outcome as lumpectomy and rads.

It's a very difficult personal decision.

Michelle

My mother has Alzhiemers and I know she could not handle the radiation treatments.

I'm sorry about yuor situation.  I'm not sure what you can decide --or evne if there is anything to decide--until you know what kind of cancer you are dealing with. 

Years ago, my great grandmother had breast cancer.  She had surgery to remove the lump and nothing more.  She was in her 80s at the time.  Her doctor told her that at her age, the cancer would be likely to grow slowly and that any treatment would be worse than life with the disease.  In the end she simply died at 94 of old age.

I hope its not offensive and I don't mean it that way but I find myself thinking of what a vet told me about a beloved cat with cancer.  He said he could operate and we could do chemo but it would all be for me because my cat wouldn't understand what was going on and would only know that it was in pain and was suffering and the life that was left would be miserable. I guess what I am trying to say is that I think you have to consider what her degree of dementia is and what your reasons would be for putting her through the process.

good luck with such a hard decision.

These are such difficult decisions. My Mom recently passed away with end stage heart disease and had a questionable mammograms a few months before. She was able to make her own decisions with some support. There were no options left to deal with here heart disease-she was maxed out on meds,had no surgical options and it was felt that she would not make it off an OR table or manage treatments. Her decision was to come home w hospice. None of her treatments changed but she received additional support during this difficult period. And she had the best time of her life. Sometimes I believe we wait too late to bring in hospice services which benefits both the patients and the caretakers. Mom did not have to give up any of her current treatments, was able to receive meds to control her symptoms, and managed the end of her life as she did her entire life. When she passed, it was at home, she was comfortable and it was in accordance with her wishes. Most hospitals also have wonderful ethics committees to help you and your family as you process these decisions.

My mother had Alzheimer's and then a mammogram that showed something suspicious.  The surgeon came right out and said my mother was not "healthy" enough for surgery as the anesthesiology was enough to topple her over.  I would be surprised if a surgeon would take her on if she has true dementia. She must consent to surgery and the risks and can she do that? 

At her age would not the cancer be very slow growing? Good luck.  I personally feel most doctors owuld be hesitant for surgery OR radiation.