Greetings..
I am so glad I found this forum.

My 88 year old mother recently told us of a "mouth sore". A quick visit to her dentist (who she had seen five months earlier) and we were immediately referred to an ENT for an exam.

He ordered a CT Scan and the results show:

"Soft tissue mass along the undersurface of the hard palate which is asymmetric to the left concerning for a squamous cell carcinoma. The mass measures at least 2.5mm in greatest dimension and extends to the palatine foramen which is widened when compared to the contralateral side concerning for perineural tumor spread."

"Bilateral level 2a adenopathy concerning for nodal metastasis consistent with N2C disease"

Here is my dilemma. My mom has an activated POA due to dementia, congestive heart failure and aortic stenosis. The hard palate cancer is the most recent addition to her list of medical issues.

On the one hand, I have her geriatrician recommending palliative care and, based on his referral, she was admitted into hospice care.

On the other hand, I have the ENT who is suggested surgery (60 - 90 minutes) in order to remove the growth. He said that she would be able to handle the surgery and while she may emerge from it with a "rather lengthy period of delirium" she wouldn't have the prospect of living out the rest of her life with a growing tumor.

My Mom is living in an assisted living apartment and gets great care, yet I am worried that if she has the surgery it could throw her into a skilled nursing environment.

She is mobile and enjoys going to the craft room at her assisted living facility. She said that her mouth isn't sore all the time.

She is confused as to what is going on and I am freaking out over the conflicting advice I am getting.

I know my mother is approaching the end of her life and I want her to have a peaceful and pain free death. In listening to the ENT today he made it sound like it would be horrendous absent surgery. He said that the surgery wouldn't extend her life but could eliminate pain. (after a period of painful recovery from the surgery).

I'm am at a loss as to how to proceed. My mom placed her trust in me and I don't want to make the wrong decision. Any advice is greatly appreciated.

Greg