Recurrent Ovarian Cancer - 1259705

popcorn1
Posts:3

My mom 81 had Stage 3c ovarian cancer in 2008. She has received chemo 3 times, the last of which was etoposide and on her 4th re occurence of cancer. Latest PET scan shows that lymph nodes in renal area light up at SUV 7.8 and thyroid 29.9 SUv. She isn't sure she wants anymore chemo. Is this a wise decision? I know this is serious but how serious? I know no one knows what her life expectancy is but if we had some idea it may make her decision easier. With chemo and with out and estimates? Original Dr said after surgery maybe 5 years she is going on 6 but not an easy six years. This is a difficult subject to speak of.

Thanks for any info you can give me.

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Reply # - October 7, 2013, 01:39 PM

catdander
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Hello popcorn, I'm very sorry your mom is going through this. This is at least one of the toughest decisions and discussions in cancer care; when does chemo cause more harm than good. There's no way anyone even the treating doctor can say how long a person may have to live but a doctor may know the likelihood of someone living longer, or shorter, on chemo than off chemo. One perspective our faculty use in this decision making process is what the person with cancer wants. Chemo in an 81 yr old whose been there is likely to be a very good judge.

There have been some very frank discussions on this subject. This is probably the most frank, http://cancergrace.org/forums/index.php?topic=5558.0

http://cancergrace.org/coping-with-cancer/2010/12/30/transition-to-symp…

I'm not sure any of the above links mentions this but there were data on trials presented at ASCO 2 or 3 years show comfort care without anti cancer treatment at the right time can increase both longevity as well as quality of life.

I hope you will look at these and continue the discussion,
Janine
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Reply # - October 7, 2013, 08:52 PM

Dr West
Posts: 4735

Honestly, this is a question that is as philosophical as it is medical, but there is plenty of wisdom in questioning whether it is helpful to continue treatment, which we sometimes do just because of momentum. Sometimes, oncologists recommend/offer it partly or largely because they assume that patients will always want more, but they may be happy to give a thoughtful discussion of the pros and cons rather than just reflexively favor more. And even if the oncologist favors chemo, it will be helpful to hear the argument about why and how beneficial it might be. Good luck.

-Dr. West

Reply # - October 8, 2013, 01:03 PM

popcorn1
Posts: 3

Wow. What a moving article in you sent me the link to. Mom told onco she doesn't want any more chemo. I kind of agree with her wishes. Just wondering what comes next who do we speak to about hospice. Oncologist wasn't very helpful he was non committal in benefits of chemo and time with or with out. What symptoms and issues will she be confront without chemo?

Thanks

Reply # - October 8, 2013, 04:19 PM

catdander
Posts:

How unfortunate that her onc isn't willing to discuss this openly. If your mom is done with chemo it might not matter what may or may not happen. Too the onc may have been non committal because it's very difficult for an onc to say how one person may respond to an anti cancer treatment.

Perhaps your mom (or you if you go to appointments with your mom) can prepare herself to discuss hospice with the onc by reading up on hospice care. Too many oncs are so uncomfortable with the subject of hospice that their patients end up not benefiting from it. There are quite few blog posts about hospice that I'm sure will help you understand better how it may go.

2 of my favorite, http://cancergrace.org/cancer-treatments/2011/03/10/what-is-hospice-fac… http://cancergrace.org/cancer-treatments/2012/08/12/hospice-is-help/

For more than you care or need to read this is the link to the "General Cancer Info"/coping with cancer blogs, http://cancergrace.org/coping-with-cancer/

I hope this helps and keep us posted,
Janine

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