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should an 87 year old seek treatment??
My 87 year old father was always in excellent shape, living in Colorado and playing tennis several days a week. He was feeling fine and even played tennis 2 or 3 weeks ago. But then he noticed blood in his urine and started feeling tired and achy (in his left leg and lower back). My sister who also lives in CO (I live in NY) took him to a Urologist who during his initial check up was quite certain it is Bladder Cancer. To get a definite diagnosis though, he would have to do a biopsy that would involve surgery.
My dad doesn’t even want to take that step because he doesn’t want to have any surgery or treatments at this stage in his life. He is resigned to just letting it take its course and feels already with his body aches and lack of energy that it has already spread.
My questions are:
1. Don’t you think he should at least get the biopsy done so he can get a proper diagnosis?
2. Do you think that if he was feeling fine 2-3 weeks ago playing tennis, that it could have advanced and spread so quickly?
Any advice and thoughts would be greatly appreciated.
Best,RGeltman
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6 Replies
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Your mom is blessed to have a daughter like you. You respect and support her when she needs it and honor her decision.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator -
My mom was 86 when she was diagnosed with small cell bladder cancer this January. Her symptoms were bleeding while urinating. We sought treatment at MD Anderson. Because small cell is so rare in bladder cancers, they treat it as lung cancer, which is also small cell. She went through the cysto easily and the surgeon removed the tumor that was there. However, they found a slightly enlarged lymph node next tot he bladder that was suspicious. Before the diagnosis, philosophically she didn’t ever want to take chemo. After the diagnosis, she chose to go through the first round, which was four treatments two weeks apart, and then decide from there. These were done in order to kill any cancer cells that may have been in her body, but were invisible in the scans, and to shrink the lymph node if it was cancerous. She weathered these treatments very well. She is like your dad, not the typical 86 year old. After the four treatments, we were advised that her node had not responded and the tumor had returned. And since there was no research to provide alternatives for cure, there was nothing more they could do. They had given her the platinum treatment and her disease was nonresponsive. That was in late April this year. Since then, she feels fine, her hair is growing back, and she has had a great summer. And we with her. She is 87 now. Three days ago she started bleeding again, so she is deciding whether the time is right for palliative care. She does not want any more treatments. She’s in good spirits and feels fine. This is a strange disease, because you feel fine and you don’t look sick. At least now. I don’t know how it progresses. I haven’t any information about that.
I’m telling you my story so you can see how my mom handled this for the last 8 months. The decision is truly up to your dad. We are fine with her decision. My dad “chased the dragon” and had no quality of life for the 18 months he lived after his diagnosis. With my mom, we will take it as it comes. Good luck. I hope your family can move through this time with peace.
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My Dad was 80 when he underwent the surgery to remove his bladder and prostate. The day before surgery, he was on the roof of his house cleaning the gutters! He was really strong. After the surgery (which had lots of complications in his case) he was never the same. He never said so, but I think he regretted ever going under the knife. The fact that his surgeon was not the most competent did not help matters. He survived until last year when he passed away at age 86. The cancer came back to his ureters. With that said, your Dad has to make his own decision but really should have all the facts before that decision is made. My Dad refused to treat the recurrence because chemo was not a path he wanted to take. He did not want to have tests done because he had already decided that further treatment was not what he wanted. This is a VERY difficult surgery and hard on even the younger ones who have it.
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Surgery involving the bladder is a different method of getting in there to perform the biopsy. Did the doctor explain just how it is done? Taking a few hours to get a definite diagnosis would be worth anybody’s time. Once known, personal decisions can be made. If more serious, he has the right to deny treatments. Quality of life would probably be more than just a few aches and pains. Good luck to you both.
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I would follow Sara Anne·s advice- The biopsy surgery will give the information that he and his medical team needs in order to decide what if any treatment is required.The pain and achiness is not necessarily connected to any bladder problem, but when you think you may have cáncer, your mind immediately decides that any anusual ache or pain is the spread of the disease. The sooner he has a definite diagnosis, the sooner he can make decisions.
Tell him you can·t scrap your classic car because it has a little leak, you get the mechanic to take a look, cos maybe its no big deal to fix it.
Diane -
It hasn’t even been positively diagnosed as bladder cancer!! What the urologist is proposing is a TURB (transurethral biopsy of the bladder) which is done under general anesthesia, but is not really like major surgery. I have had two…both time came home the same day. I would compare this to an endoscopy, which is often done to check the stomach for ulcers, or to a root canal (I would rather have the TURB than a root canal.) Sometimes, it is necessary to spend the night in the hospital, but not always.
IF the diagnosis comes back “bladder cancer” a lot depends exactly on what the pathology (examination of the pieces of tissue taken during the biopsy) says. It could be a very low grade, unagressive, papillary tumor which doesn’t even require further treatment, just careful watching. It could be a slightly more serious tumor type and there are non-surgical treatments which can be very successful. An 80 year-old neighbor of mine just finished 6 BCG treatments and is playing golf in Palm Springs just a week later. Of course, the diagnosis could be much worse.
It would only be after the diagnosis is complete, after the TURB, that your father would be in any position to make any decisions as to whether he would want treatment or not, depending on the treatment options.
I would encourage him to have the biopsy surgery and THEN discuss his options.
Best of luck to you both.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
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