Concerned Daughter,
First, thank you for being there for your mother. It is a tough job; somehow it seems and feels so different than arriving at medical decisions for our children. All I have to offer is my experiences.
As a son in that position, I asked what dad thought – he was not sure. His living will spoke of his preference for quality of life above length of life. His regular physician knew more about his underlying condition than I did – there were things dad chose to not share with me previously. I engaged his GP, and two specialists, with dad present, then we spoke with the doctor who proposed a procedure. We were able go come to an “informed” decision. Informed, in quotes, because dad was not as sharp as he had been when we were both younger; “decision” because dad chose an option.
As a bladder cancer patient, I would want more info from the urologist.
– There is a tumor diagnosed, but it has not been biopsied; it is unknown if it is cancer at all, let alone if it is high grade or low grade – that is, how likely is it to grow and spread ?
– Is there a single tumor, or are there many ?
– Has cytology testing been done – examining a urine sample to detect and evaluate cancer ?
– Is the tumor suspected of causing problems or discomfort at this time ?
– It is unclear if there are ‘problems’ now. Is there a time line for possible future problems ?
– What does her GP think of the timeline answer ? How does it fit life expectations ?
– With a concern about anesthesia, if a single tumor, is a biopsy under light sedation an option? This is really asking the question, would she accept local pain, treated with pain and anxiety meds, to avoid general anesthesia if a saddle block is not possible ? Would the urologist agree ?
– Has an anesthesiologist offered an opinion on the saddle block ?
And the big question – What does mom think about all of this ? What does her full care team think ?
Whether the tumor is or is not causing current, worsening problems that bother mom, may be a big part of the decision.
Use all the medical resources you have available to find an option with a likely best outcome. Unfortunately, there are no guarantees in medicine, all we can do is choose from options.
Again, just my thoughts.
Best,
Jack
6/2015 HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one & only kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo# 3
Begin year 4 with cis
2/19 Chemo #4
9/19 NED again :)
1/2020 CIS is back
Tried Keytruda, stopped by side effects
Workin on a new plan for 2021