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Confused about testing for my mom after meeting second oncologist

Posted by margingeorgia @margingeorgia, 5 days ago

My mother (85) was told she has colon cancer based on CT scan (thickening of ascending colon) and bloodwork. She was first told she also had liver cancer in the ER bc the CT scan showed lesions on her liver. We went to one onc (awful, dismissive), who said it was definitely colon cancer, not liver cancer (my mom had liver hemangiomas from years ago, discovered during surgery for stomach cancer). Once my mom heard cancer, she said, that's it, no more doctors, no more tests, no treatment. We respect that decision.

However, I did set up a consultation with another onc (so much better, explained things well). She said there could be other reasons for the thickening of the colon wall that might not be cancer. My mother has a CEA of 4.39 and is anemic. She has no energy, has lost significant weight and muscle mass, and is essentially bedridden.

Like the other onc, the second one wants to do a colonoscopy. My mother doesn't want additional tests, and I really want to respect her wishes, but if there's a non-zero possibility that this isn't colon cancer, then I think we should pursue more tests.

The second onc is going to confer with her liver cancer colleagues to make sure that my mom doesn't have liver cancer (the onc said she had bile duct enlargement, in addition to the lesions on her liver, which she says makes her spidey senses tingle).

I guess my question is: I know oncologists will not say definitively whether someone has cancer without a tissue sample. But I have been told that colonoscopies can be dangerous for someone her age, and given her current health condition, I think she would respond poorly. Could I try to convince the oncologist to give me an educated best guess? Just trying to figure out what to do next. I'm anxious that I might be missing something. Thank you.

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roywalton | @roywalton | 5 days ago

That's a very tough situation. In my opinion I think it's best to do what you can to meet her wishes. The real issue is probably her overall condition and along with her age, any surgery may not be advisable, not to mention the chemo and recovery issues that you would have to deal with. At some institutions colon cancer is not treated at 80 years or older. The colonoscopy itself carries little danger to the patient, but again what would you do if you could positive results from a biopsy? And that is just the colon, if you do a biopsy of anything found during the colonoscopy you'd almost forced to have to do a biopsy of the liver as well. If I were the person who at 85 had come to the realization that I might have cancer, and that it might be stage 4, (especially after having cancer at age 70), I would probably seek to spend my last days in the most pleasant way possible with family and friends.

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roywalton | @roywalton | 5 days ago

That's a very tough situation. In my opinion I think it's best to do what you can to meet her wishes. The real issue is probably her overall condition and along with her age, any surgery may not be advisable, not to mention the chemo and recovery issues that you would have to deal with. At some institutions colon cancer is not treated at 80 years or older. The colonoscopy itself carries little danger to the patient, but again what would you do if you could positive results from a biopsy? And that is just the colon, if you do a biopsy of anything found during the colonoscopy you'd almost forced to have to do a biopsy of the liver as well. If I were the person who at 85 had come to the realization that I might have cancer, and that it might be stage 4, (especially after having cancer at age 70), I would probably seek to spend my last days in the most pleasant way possible with family and friends.

You might also choose to have the CT interpreted by a different radiologist

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isadora2021 | @isadora2021 | 4 days ago
In reply to @roywalton "That's a very tough situation. In my opinion I think it's best to do what you..." + (show)
@roywalton

That's a very tough situation. In my opinion I think it's best to do what you can to meet her wishes. The real issue is probably her overall condition and along with her age, any surgery may not be advisable, not to mention the chemo and recovery issues that you would have to deal with. At some institutions colon cancer is not treated at 80 years or older. The colonoscopy itself carries little danger to the patient, but again what would you do if you could positive results from a biopsy? And that is just the colon, if you do a biopsy of anything found during the colonoscopy you'd almost forced to have to do a biopsy of the liver as well. If I were the person who at 85 had come to the realization that I might have cancer, and that it might be stage 4, (especially after having cancer at age 70), I would probably seek to spend my last days in the most pleasant way possible with family and friends.

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@roywalton I have continuing guilt over my mother’s passing 18 years ago. We pushed her to do things she didn’t want to do because we didn’t want her to leave, and they weren’t helpful anyway. It has convinced me how important it is to listen to what our loved ones want. My father is 90 in a couple of months and still has colonoscopies to remove polyps. I am sure if he is diagnosed with something serious he too will choose to make the most of whatever time he has left with only palliative care. This time I will listen.

So very hard ❤️‍🩹

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celia16 | @celia16 | 2 days ago

My great aunt, who was in her 80s, had digestive issues and once hospitalized it was determined that she was too weak to undergo tests and any treatment for cancer, if that’s what it was. They suspected cancer. She made the decision and her family agreed. She was discharged to rehab.

I think respecting their decisions is important. Can they treat the thickening as if it’s not cancer and see if it responds? I hope the doctors can help you arrive at a good plan or course of action.

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