Are cancer screening worth the stress if you have Alzheimer's disease?

1 answer | Last updated: Sep 14, 2017
A fellow caregiver asked...

My mother is in late middle stage AD at 83 years old. Her doctor has recommended that, based on her age, she should have several cancer screening tests, including a colonoscopy. I know these invasive tests will be very traumatic for my mother, as she won't understand what is happening and why. I am also not sure how aggressively we would want to treat any illness that was discovered, so I question the value of putting her through so much fear and discomfort. I'd appreciate any feedback from doctors or family members who have dealt with this issue.

Expert Answers

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

Screening tests are designed to find potential cancers. They are really recommended for healthy persons who want to prevent a potential cancer in the future. So, what should you do if someone is frail, elderly, or would have problems with the screening tests? Fortunately, several organizations, including the American Cancer Society and the U.S. Preventive Services Task Force (USPSTF), have published guidelines on this same question.

The USPSTF does not recommend routine screening colonoscopies for colorectal cancer in adults aged 76 to 85 years due to the risks associated with the procedure. These risks include becoming weak, faint, and nauseous from the fast and the bowel prep solutions you must take to prepare for the test. Furthermore, the procedure itself is also risky. These risks include possible perforation of the colon and adverse reactions to the sedative medications used during the procedure.

My recommendation would be to tell her doctor you are not interested in doing any screening tests with your mother due to her age and her dementia. Good luck!