My mother who is 80 just found out that cancer has spread to her lung, on the right side same as the original tumor and lymph nodes. It took a week and a half to get the results of her biopsy. The dr who did her 2nd surgery in Feb.2002 is sending her now to a thoracic/pulmonary surgeon next Wednesday. I'm guessing from what the ENT told her over the phone that the recommendation will be more surgery to remove the tumor and portion of her lung and possibly more radiation or chemo. Needless to say she has had the wind knocked out of her by all of this. She had been doing relatively well at home on her own for the last year. I wonder when it is time to say enough is enough when it comes to invasive surgery. At this point I think my mother is so numb she will go along with whatever this doctor tells her. The whole idea of more surgery and radiation at her age and in her already compromised situation from previous treatment sound almost cruel. I guess we will have to see what the latest doctor has to say about her options. Not trying to depress anyone here, but am wondering if anyone has gone through or is going through the same situation with an older parent or friend? My mother is not one for self pity, but I am sure she is not looking forward to what is coming next.

This post could open up a philosophical debate that could go on for years. I am not going to start that debate here, though it is something that we should delve into sometime in the future. Obviously, there comes a point in a patient's life, where the burden of the treatments and the predicted outcome (if not significantly positive), outweigh the benefits obtained from those treatments. Only the person who is affected directly by the disease can make the decisions to proceed or not. While today I might say that I personally would fight the fight even at the ripe age of 80, and that I would

Lance Armstrong had cancer in three different areas, was treated and went on the win the Tour De France (more than once). Not that this is a strong parallel with your mother. My father got married to his second wife (after my mother died) when he was 85 and told me that those were the best years of his life. She, unfortunately died of lung cancer six years later. My father lived to 92 and passed away from Lymphoma. I have a close friend with lung cancer and she is being successfully treated with chemo and radiation. I think that Brian covered the philosophical aspects extremely well and there are no easy decisions within the context of this disease. I was also blessed with being a primary caregiver for my father in his last months and it was a very spiritual experience. We had the assistance of Hospice care which demystified the process and was helpful beyond words. What always surprised me about my dad was how much he loved life, despite the handicaps, limitations and pain. He fought to the end and gave me the ultimate gift of being a living role model for me now that I am the cancer patient. People get discouraged, think about it, take off the gloves and then come back fighting it's part of the human condition.

Vince,

My family is in a similar situation. My mother, who will be 85 next week, had surgery for tongue cancer last June and did fine for a year. Today we learned that the tongue cancer has recurred and that she also has cancer of the soft tissue of her neck under her ear. The doctor said the "give it all you have" approach would be seven weeks of radiation treatments five times a week with concurrent chemotherapy.

He offered an intermediate treatment the goal of which would be to "buy her some time"...just enough radiation to slow the growth of the cancer but not so much as to make her really sick.

She is in a state of high anxiety right now and I am feeling a bit lightheaded when I think about all this. Maybe we will be more clearheaded in the morning. We are going to give ourselves several days to discuss this and for her to make a decision, but it is a difficult position to be in because neither alternative (or the third one, to do nothing...which is the option she is leaning toward)is very pleasant. Brian is right: no one prepares us for these kinds of conversations.

To all of those who posted
I've been a nurse all my adult life and no truer words are spoken then Brian's We are not prepared for this as a society. To freguently the family lets their loss get in the way . It truly is the persons decision who has to go thru this and their choice should not be overly influenced by a desire to please the well family member. I wrote this not just for the original post but because I need to remind myself daily to follow this advice. It's not easy to do but listening and really hearing the true wishes is the fairest thing to do in a situation where none of this journey is fair, My best to all of you
Diane

Thanks for the responses. As of now my mother is scheduled to see her ENT regarding any issues that would be involved from that end during surgery to remove a lobe from her right lung. She too, is leaning towards not doing anything. She dreads another trache and feeding tube and she is not as strong as she was when she had the first two surgeries. She is also convinced that more surgery will cause her to be unable to care for herself and end up in a nursing home. And most important is the dread that she will go through all this again only to be told that cancer has turned up somewhere else. It is a difficult situation and it is hard to have the conversation as you mentioned. We shall see.

I hope this time together and the decisions that you make bring all of you closer together as you jointly open up to each other, and deal with the most difficult of questions. The end result is that a deeper love will be communicated and shared between you all, perhaps more than you have experienced before in life. This can be an extraordinarily painful experience emotionally, but one which is essential to go through, and the results of which are worth the pain.

On a more practical note, when you mention the "3rd option" which is to do nothing as being more pleasant, you need to think this through carefully. A death from a metastasized oral cancer is not pleasant. In comparison to other ways to go, it is nowhere near the top of my wish list of a way to leave this earth. Before you let anyone chose to do nothing, please have one of the doctors explain what is likely to happen, what the physical manifestations of this will be, and to what extent the associated pain can be managed. Besides pain there are other very unpleasant issues that are not as easily managed. I do not wish to elaborate on this here on the board, but you should discuss this option in extreme detail with an appropriate doctor before heading in this direction. This journey will change all of your forever, in ways that in some distant future, you may reflect on as very positive. I know that sounds impossible now, but with the cushion of time between the experience and the end revelations you end up with, this may be the case.

Just to clarify, "do nothing" is my mother's and the doctor's term for not having any radiation. By that we mean using hospice and palliative care.