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Bowel cancer - surgery or not?

memyselfandi

Registered User
Mar 1, 2017
11
0
Dad's Possible Colon Cancer

Looking for opinions and/or advice on the following:

Mum lives in a nursing home. She has Alzheimers, she is happy and chatty when we visit, but I understand from the carers that she increasingly spends time in her room and gets very upset as she misses dad (who died last year). She is declining food a lot and hardly eats at all - she has dropped about 30lb since Christmas. She is able to walk with a frame but gets out of breath and faint. Recently she has been diagnosed with cancer of the colon. The tumour has probably been there for a long time but has now been found after investigations re anaemia, discomfort, and the not eating issue. We are told that she lacks the capacity to legally consent to surgery and that (if she is deemed fit for an op) it will come down to a best interests decision. She herself is very gung-ho and keen to have an op - but I think her self-image is of a younger and fitter woman. She does not retain information easily - and forgets what the doctors have said immediately after it has been said. I worry that she would not be able to follow instructions in hospital, nor be able to provide them with information about her well-being.
My worry is that it would be a major operation and could leave her worse off than she is now both physically and mentally, and I think it would be better to go the palliative route and let nature take its course (quality of life over quantity). We don't know whether there has been any spread or not.
Does anyone have any opinion or advice they could offer me, anyone been through this situation? I don't want to lose mum but I also don't want what time she has left to be ruined. My thinking goes round in circles a bit and I don't know whether my fears are realistic.

The last time my dad was in the hospital, they found that some of his blood levels were off, leaving him anemic. Their worries were that he may have some internal bleeding and wanted to do a colonoscopy.

Well, with a procedure such as this, my dad would have been required to drink a very large amount of fluid; something I knew he wouldn't be able to do as he also was recovering from aspirational pneumonia. They suggested putting a tube down through his nose and into his stomach so as to get the fluids into him. My first question was, "How in the world are they going to keep that tube in his nose without him pulling it out, since they can hardly keep an IV in him without him fiddling with it and getting it out no matter how much they wrapped the IV area.

The person that was to perform the colonoscopy came in and told me it was an easy procedure and they should have no problems, yet my dad is 88 years old and I too wasn't sure how he'd handle local anesthesia, etc.

Rather than make this decision on my own, I called my dad's family doctor for advice. He came up to the room and told me that the change in his blood levels could be part of his body adjusting to the medications he was on, etc., and that he would see what his levels looked like in the morning. No sense putting him through a procedure like this at the age of 88 if it wasn't necessary. He also said that if there was any sort of cancer in his colon, it was a slow growing cancer and that wouldn't be what would kill him.

At that point, my dad hadn't been eating either, yet had no discomfort. He also had dropped 40 lbs in three months and was anemic.

My dad's physician suggested not having the colonoscopy as at his age, there could be many things that could go wrong such a perforation of the colon (where while they were going in with the scope, they could accidently put a small hole in the colon, causing severe issues of bile entering his system, etc).

Even WITH a colonoscopy being done, if they DID find something, putting an individual at my dad's age of 88 would be more a risk than a finer quality of life. We decided to leave it be as my dad is in no amount of discomfort.

In your case, I would check with your family physician and see what they say. Oftentimes surgeons don't know the person's entire history, etc. Your mom's family physician knows her medical history better than anyone and they may be able to set your mind at ease as to whether you mom is a true candidate for this type of surgery in addition to how well she might bounce back from it.

A question I have for you is that you mentioned that your mom is unable to make medical decisions on her own. Has your family appointed someone to be her Medical Power of Attorney and have it activated by an MD so that your family individual can make medical decisions for her? This will come in handy rather than just going by a best interests decision that her physicians will make for her. Without this piece of paper, you probably won't have much say if she's "gung ho" about it while she suffers from Alzheimer's. Rather than you deciding, it will be up to her physicians; and under the circumstances, they may choose not to do the surgery.

In most nursing facilities, they already offer Palliative Care. I would let nature take it's course and let your mom live the rest of her days without the pain the surgery may put her in as older folks don't heal as well. She'll need to stay In the hospital longer, where the chances of getting pneumonia, etc., are higher since it's just in the air. My advice is to take her back to her nursing facility and let her enjoy the rest of her life there. Hopefully it's a slow growing cancer and she'll live longer than if she had the surgery.

In my dad's case, we refused the Colonoscopy and decided to let nature take it's course with him also. Since the sepsis has been alleviated, along with his aspirational pneumonia, he is now eating well and is stable. Hopefully this will be the case with you mom and she'll have a better quality of life with Palliative Care and family seeing her often, showing her love, and giving her a purpose.

I hope I've helped. If you have any questions, just submit a reply and I'll do my best to answer them. God Bless.
 

Daughteriam

New member
Oct 27, 2020
1
0
Looking for opinions and/or advice on the following:

Mum lives in a nursing home. She has Alzheimers, she is happy and chatty when we visit, but I understand from the carers that she increasingly spends time in her room and gets very upset as she misses dad (who died last year). She is declining food a lot and hardly eats at all - she has dropped about 30lb since Christmas. She is able to walk with a frame but gets out of breath and faint. Recently she has been diagnosed with cancer of the colon. The tumour has probably been there for a long time but has now been found after investigations re anaemia, discomfort, and the not eating issue. We are told that she lacks the capacity to legally consent to surgery and that (if she is deemed fit for an op) it will come down to a best interests decision. She herself is very gung-ho and keen to have an op - but I think her self-image is of a younger and fitter woman. She does not retain information easily - and forgets what the doctors have said immediately after it has been said. I worry that she would not be able to follow instructions in hospital, nor be able to provide them with information about her well-being.
My worry is that it would be a major operation and could leave her worse off than she is now both physically and mentally, and I think it would be better to go the palliative route and let nature take its course (quality of life over quantity). We don't know whether there has been any spread or not.
Does anyone have any opinion or advice they could offer me, anyone been through this situation? I don't want to lose mum but I also don't want what time she has left to be ruined. My thinking goes round in circles a bit and I don't know whether my fears are realistic.
I am new to this. Your message mirrors my dilemma . What do I do. She is in hospital admitted as so un well with colon cancer. A x
 

Shedrech

Volunteer Moderator
Dec 15, 2012
10,732
0
Yorkshire
hello @Daughteriam
a warm welcome to posting on DTP

I'm sorry your mum is so unwell and in hospital ... I hope you will be able to visit her .... maybe contact the Patient Liaison Service PALS at the hospital and ask for their assistance

There may be something useful in this forum (as this is an old thread, the members who posted may no longer come here)