We, my mother, sisters and I, learned this week that Momma has stage 4NAM0 cancer in her lower mandible. My mother is 90 years old - mentally strong but physically quite frail, exhausted by this last week of tests.

The options that have been offered as a result of her case's review by a local hospital's tumor board are:
1) The "standard" surgery to resect her jaw replacing it with a titanium rod and neck dissection to remove the affected nodes, or
2)a palliative course of radiation therapy - 10 treatments to try to abate the growth of the tumor.

Although there is a chance that the surgery could eliminate the cancer in her mouth/neck, we are concerned that she would not survive the procedure or recovery. And then there is the possibility that the cancer could appear somewhere else, after having gone thru such a difficult procedure.

We are so conflicted - and so overwhelmed with this decision.
In a way the prognosis seems terminal either way. Does the options seem to make since - given the (admittedly limited) description provided. Should we seek a second opinion, even though her case was reviewed the hospitals tumor board?

Has anyone had a similar

I (and my mother) went through a similar choice when she was in the last stages of her rare leukemia. Various drugs (including two NIH trials) had initially produced a remission, but the disease came back with many serious side effects, including lymph node tumors, lymphedema, etc. and the NIH doctors felt that no existing treatment would induce remission. She opted for palliative care and that was, for her, the best decision. Similarly, a friend with abdominal mesothelioma finally said "enough" to his treatments and went into hospice care, and again it was best for him and his family.

I would consult with hospice and also, with those who would oversee palliative care to see what they will do as the disease progresses -- to ensure that your mother is as comfortable and pain/stress-free as possible, If you are not happy or comfortable with their answers, by all means seek a second opinion. I would also spoeak to one of the hospital social wokers as they can help you deal with the emotional stress of having to make such a difficult decision.

The Hippocratic oath says "first, do no harm" and I think that sometimes means NOT doing a treatment if it will cause more distess, pain and suffering than palliative care (which is, by the way, NOT "doing nothing.)

Gail