Concerned Daughter

6 years 7 months ago #53885 by Jack R
Replied by Jack R on topic Concerned Daughter
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
The following user(s) said Thank You: cltyxx

Please Log in or Create an account to join the conversation.

6 years 7 months ago #53882 by rm817
Concerned Daughter was created by rm817
My 91 year old mother was recently diagnosed with a superficial bladder tumor and the urologist is recommending she have surgery to remove and biopsy it. He said if they would do a saddle block, if they could get the needle in her vein, but if not they would have to put her under anesthesia. We are afraid at her age, that would not be good for her - hear too many horror stories of older people not waking up or having complications from the anesthesia. On the other hand, if we chose not to do it, he said there could be complications such as the tumor growing and creating other problems. Before having this done, she would have to be cleared by a cardiologist, but we are not sure we want to put her through all of this at her age.

Any suggestions?

Thank you.

Please Log in or Create an account to join the conversation.

Moderators: Cynthiaeddieksara.anne