Should my mother opt for chemotherapy or not?

2 answers | Last updated: Sep 14, 2017
Shrads asked...

Its about my mother in law 59yrs,diagnosed with ca breast stage 4,with bone mets at diagnosis in 08/2006.underwent bilateral mastectomy with chemotherapy and radiotherapy for spinal and bone mets in 2006-2007.she is HER2 negative,ER,PR positive.was on anastrazole and tamoxifen for 2 years in 2007-2009.after which she stopped it.meanwhile she underwent angioplasty of heart and December 2012 she was diagnosed with multiple spinal metastases again for which bisphosphonates were started at 21 days interval.but in June 2013 started getting hypercalcemia resistant to medical treatment,so doctor got her parathyroid glands removed as they found a parathyroid adenoma.after 1 month she started decline in her renal function,owing to Nsaids and fluroquinolone allergy with acute renal failure requiring multiple haemodialysis sessions which took almost 5-6 months to recover.with final creatinine level of1.5. But her fatigue and anemia due to bone mets are persistent,we couldn't give her bisphosphonates any in march 2014, she had a fracture neck femur for which she underwent dynamic hip replacement surgery after which she was mobile after one and half months.but recently in first week of may 2014,she is diagnosed with multiple liver metastases and peritoneal nodes as well which is causing her severe abdominal pain,anorexia and fatigue.our oncologist has suggested chemotherapy who sees her once in 6 months,other doctors who are seeing her quite often like neurologists,nephrologist,cardiologist and other close caregiver,her son who is doctor as well are against chemotherapy cause her quality of life is deteriorating day by day over past 1 and half years.but m father in law and brother in law want to give her chemotherapy.she doesn't know about this and chemotherapy also,given her a chance to choose,she would definitely opt to die us,give suggestions please.

Expert Answers

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

Chemotherapy is something that sounds great. Most everyone wants to live longer. It is important to understand though that people do NOT have to accept chemotherapy.. There are always trade-offs, usually in quality-of-life; either side effects, time required at the hospital, or even waiting and hoping for improvement, when it might be more appropriate to accept that we all die one day. At some point it is futile to keep trying. Your mother-in-law is young, and she has fought a strong fight. It sounds like she has done everything she can. Now with the cancer affecting many of her major organs and her quality-of-life declining, it would appear that chemotherapy has very little to offer her. Some people would still want it and that is fine, but from your last line, it appears she does not. To help her have the best quality-of-life until she dies, she should get hospice involveed or at least see if there is a palliative Care doctor in your area (usually at big medical centers). It sounds like her priority now is her comfort. Unless the oncologist can guarantee you of that, it is best not to do the chemotherapy. Saying NO to more treatment is NOT SUICIDE. It is accepting the fact that we all die one day. Your mother-in-law has the right to say NO MORE TREATMENT. If those are her wishes please do your best to follow them.

Community Answers

Januaryraindrop answered...

I have a question I'm not sure if I put this in the right place or not. I had breast cancer twice at the age of 27 and at the age of 37 they came back I had a double mastectomy after several surgeries for two years I was in medical health in my stomach cuz I had a trans flap my stomach was wide open at one time I had a wound vac anyway I opted out of chemo it was my choice because they said the risk was 30% so my odds of survival at 70% which is greater and I went through chemotherapy when I was 27 and it was hell really I can't go through it again it gave me PTSD what I went through and I'm having a hard time getting SSI keep having to appeal I don't understand I hope for my PTSD so I guess my question is if I opted out of chemo and I had a double mastectomy am I in remission or do I still have cancer cause I didn't have chemo?