MIL is in assisted living. Early this evening we rc'd a call from a nurse there who said my MIL came to her saying her breast was hurting. The nurse took a look at it and found she had a very large hard lump. Her son, my husband, headed right down and took her to an urgent care clinic, doctor there sent them on to ER. After several tests, etc a doctor came in and told them it is not an infection and he and the other professionals who both examined her and reviewed the tests believe it is cancer. We will get her in to appropriate doctors on Monday if possible. Based on the information the doctor got from my MIL he thinks is is an "aggressive" cancer. The lump is the size of a fist. She had not complained of breast pain prior to this (that we know of). She stopped wearing a bra several months ago because it was irritating an area she had shingles at. They also diagnosed a bladder infection at the ER. She seems to only be concerned with that right now which is not surprising. Hospital said she could stay there or she could go home. Of course we wanted to have her come to our house, but she wants to go back to her place. We did not push her to come here and did not push the C word on her. Just given the limited information at the moment can anyone offer any insight for us. What things will we need to be certain to ask? We will see her tomorrow. BTW ER is a nationally recognized hospital. It is a long way to Monday. Thank you.
Waiting and worrying is hard but it seems you MIL is not yet worrying which is the most important thing
If you have a referral to an oncologist from the hospital then I'd suggest getting a notepad that you can take to the appointment - write down a few questions before the appointment and try to take notes during the appointment if a lot of information is thrown your way
The only advice I can offer is not to jump the gun. Sit tight and wait until you have more certain information about what exactly your poor MIL is facing; and make today as pleasant and light-hearted as you can. If it does turn out to be bad news - prepare for the worst, hope for the best - you will all know soon enough; so while I know this is easier said than done try to put the worry aside so that at least you can enjoy the moment.
If your MIL decides she does want to talk about it, though, that's different. But all the same the only truthful answer you can give her, to just about every question, is "we don't know yet." I hope her bladder is more comfortable today, anyway - that's all she needs, poor love.
Would your mil be able to cope with radiation, chemo, mastectomy? How will they determine if this is cancer and what stage? Can the biopsy ( if that's what they need to do be done in the hospital and not outpatient ( i would have opted for leaving her in the hospital, but that's another story).
Does MiL have dementia? Can she make treatment choices?
That would be my list.
I wouldn't make any decisions until the tests have been reviewed by an oncologist. An outpatient biopsy might be recommended, and that would be more determinative of whether the cancer is an aggressive one, and what stage it is.
Then you can make decisions whether to proceed with treatment, if at all.
Chemo and radiation are absolutely horrible on anyone, and would be harder on an 86 year old woman. If the cancer is aggressive, and is in a later stage, it would be unkind and not fruitful to put her through the slash and burn regimen of treatment.
In the meantime, research Gilda's Club and CURE magazine online to see if you can find a local Club which will offer support groups for your family, and the magazine to look for articles on similar situations - knowing how others proceeded might help you in making this tough decision.
If it were me, unless the cancer was stage I and the treatment was merely medicine (no slash and burn), I wouldn't consider putting any of my family through the hell of chemo, radiation and/or surgery.
There is no basis for making assumptions about the nature of a lump. She needs a mamogram ultra sound, biopsy, CT scan or MRI or whatever combination of the above they choose to do. Some of which may make her anxious but are not intrusive in them selves except the biopsy which will be done with a needle under local anesthetic and she will only feel the initial prick no worse than an injection. If she is willing any of these procedures will cause her minimal distress and at least you will know the answer and can go from there. All are outpatient procedures.
Once you have an answer MIL can decide where to go from there. They can do a simple lumpectomy, a radical mastectomy, R/T and Chemo or any of the above.
Cancer when confined to the breast is rarely painful so that is a good sign. Oncologists are very aggressive and always predict the worst.
Any major surgery has significant risks both from the anesthetic and the actual operation. At 86 it could take 6-12 months to recover. Does she want to waste a year of whatever time she has left. As it is so painful she may have a simple abscess which is easily treated with antibiotics.
Try not to think of the worst and get other opinions if it proves to be cancer. If MIL decides to do nothing which is her right and may be the sensible thing to do please support her decision. As was said above don't do the tests if you are not going to do the treatment and above all don't panic, she does not need to go for surgery this week. Give her and yourselves time.
Whenever i go to this facility for my annual mammo, i ask if anyone is there for a needle biopsy. If there are any takers, i tell them to get their valium before the procedure.
I would not have this done outpatient on an elderly patient.
"Just" calcifications which they removed. Interestingly, in the same place my mom's breast cancer was. So i feel blessed and lucky. But this was not a " nothing" procedure...and lest you think I'm a weak sister, I've had three unmedicated childbirths.
I would not put a patient with dementia through this outpatient.
If it turns out the lump is cancer, then find a surgeon who is a "breast cancer specialist" not just a general surgeon. Your Mom-in-law will feel much better with a woman specialist [unless she is of the mind set that only men are good doctors, my Mom was that way].
If the cancer is only in the breast, then a mastectomy is recommended, then that way one wouldn't really need chemo, maybe radiation or not. But radiation would also be difficult on an elder because their skin is now so thin. There are pills that one can take, but the side effects aren't user friendly.
Believe it or not, mastectomy is now an out patient procedure. If your Mom-in-law has this surgery, make sure there is someone at home to do full-time caregiving because it usually takes a week to get back up on your feet. One can barely walk the first day back home.
Hopefully immune therapy is on the rise for this cancer, where one is given meds to boost the immune system to fight off the cancer.
Comfort care might include minimal surgery. I don't want to be too graphic about it, but if there is an aggressive tumour in your MIL's breast it could all get pretty miserable and gory long before it sees her off - and in that case, it would be greatly to her benefit to be treated surgically even without any expectation of a cure.
I'm doing exactly what I said not to do: getting ahead of the information. I hope your MIL's primary care doctor is able to gee the local centre up a bit and get her seen there quickly. Please keep us updated.
At some point, the TX is far worse than the extended life they're given. My FIL had CLL (a type of leukemia). He lived 10 years past what he was told he would--but he aggressively treated everything. At the end of his life, his oncologist told me his blood looked like water, he had so few red blood cells. He was planning to do another chemo round--but his dr just said "Pal, you KNEW someday we'd get to "that point" and we're here." Dad just feared death so much, I know he fought it tooth and nail. We respected that he fought so hard. His last couple of years were awful--but he was alive and that's all he cared to be.
Honor your MIL. I hope you can find out what she wants to do. If she cannot aid in her own decision making and recovery, it will be really, really, hard on everyone. Obviously, of course, her first.
Be aware some drs are going to be "pull out all the stops" on every patient, and some are more "quality of life"---I wish you well in dealing with this.
If she has any type of dementia the anesthesia will be difficult for her.
Recovery and rehab will be difficult
Treatments will be difficult.
It might be best to leave it alone and provide comfort.
After you talk to the doctors and get all the options it might be determined that Hospice would be the best thing for her at this stage.
Ask the doctor one extra question..."If this were your Mother or Grandmother what would YOU do given the same circumstances?
My GM had Breast cancer when she was about 83. She had her breast removed. No radiation. No chemo. She died at 89 of bronchial problems. She was no stranger to cancer in her family and made what was a good decision for her situation. This was back in the 80s. A lot of progress has been made in treating cancer but my concern would be with the quality of her life after whichever treatment is offered. Make sure your MIL signs the appropriate paperwork for information to be released to you so that you are able to communicate on her behalf as needed. Hopefully all the ER records have been forwarded.
Let us know how you and she are doing.
I am sorry to learn of this diagnosis, but agree with CM, and applaud you for being on top of the situation and participating actively in this stage of her life.
Lat stage breast cancer with lymph nodes removed have lymphedema about 1/3 of the time in upper arms, chest, neck. Melanoma has the same issues with lymphedema as the sentinel nodes get removed proactively now. It's a side effect that tends to be glossed over IMO.
You can google Kathy Bates lymphedema for articles on it.
I saw my aunt suffer through lymphedema, even though she never had cancer. I made a resolution that whatever may eventually happen during the rest of my life, I won't give up my lymph nodes!