Getting confusing opinions and don’t know what to do

Posted by alexgerl88 @alexgerl88, Aug 24, 2022

Hi everyone - a relative of mine with a history of breast cancer about 15 years ago that was in remission started having trouble breathing about a month ago and was told by her primary care it was probably cardiac because of severe difficulty breathing when moving around. Long story short, after some testing it was clearly not cardiac, and a recent PET scan is showing a variety of issues, include diffuse metastatic disease throughout all osseous structures with a moth eaten appearance, pleural effusion, edema in the right frontal lobe of her brain (they suggest follow up MRI), hypermetabolic nodes in the chest abdomen and pelvis and a liver lesion. Her doctor seems very casual about these results, saying it will likely be treatable with medications to treat the bone cancer, but others are telling us she needs to be put in hospice and to get a new opinion immediately. Any advice or insight would help.

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callalloo | @callalloo | Aug 24, 2022

Well the best advice is to get another opinion or two with a situation that has so many variables, some of which might be less serious than they sound, and others really needing attention. But treatable. I'm not minimizing the seriousness but it is also true that medical diagnostic science frequently finds...then feels compelled to treat...stuff that might not merit immediate attention. The "are we overtreating?" question is the focus of a lot of articles in medical articles and online blogs.

This all depends on how your relative feels and what she wants but starting with some other opinion(s) seems like a necessity before a path forward can be even entertained with confidence. And, as hard as it is to see what someone called 'a bunch of -ologists' and understand their recommendations (and remember who said what), it's the best way to prevent later regrets of not having looked at all of the choices. And when two doctors, whom you have reason to think are excellent, concur on a recommendation, that helps a lot!