How do we decide if mom should get treatment for her cancer?

Joycejo asked...

Just found out Mom has metastases in her lungs (a lifetime smoker so not surprised) and a cyst in her kidney. She is 18 years post-colon cancer and we thought she was out of the woods. She is currently happy, meds working good, able to travel, visit, and is generally good. How do I decide whether to pursue treatment or not? The prospect of chemo in this tiny, confused person is scary. She is 87 and apart from arthritis and the like, has no pain complaints or side effects from these presentations of cancer.

Expert Answer

Andrew Putnam, M.D. is a Palliative Care physician at Smilow Cancer Center at Yale New Haven Hospital and Yale University.

18 years after colon cancer, this could also be a new cancer. In any case, it is important to talk to an oncologist to get full information. The decision of whether to treat a cancer is a case of balancing the benefits and burdens. It is reasonable at age 87, especially if your mother is confused, to choose not to pursue treatment that has lots of side effects and instead decide to enjoy better quality of life now. This is especially true if the only benefit of treatment is a very small increase in life expectancy. Some people in their 80's would still choose to be aggressive if there were a good reason for it. There is, however, no requirement for treatment and it would be perfectly reasonable to select a better quality of life now. It is almost sure that at some point the symptoms will get worse, but the benefits now can easily be worth it.