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You know how your Mom will react to the news. I would not tell her myself since nothing will be done. And she does not need to get her life together, she is in MC. I would think she has all her ducks in a row. Lots of her personal things have already been given away or sold. All she has is whats in her room. My Mom forgot my deceased Dad, my deseased sister and my middle brother. So I doubt if Mom needs to say goodbye to anyone.

This is one thing I hated about Caregiving. Having to make decisions for someone else.
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If this biopsy can be done with a minimally invasive procedure (such as through scope and under minimal anesthesia) I might consider it. Otherwise I would not do the testing even. Your Mom is of an age. Ultimately she will die, and I see little difference in knowing of what. You don't wish her to know the results of her owns tests, and I can't see why you should. As to the doctors, the orders he gives should go with the symptoms your Mom has, and scans are enough for the doctor to know, along with symptoms, whether hospice should be requested; he doesn't need to know the type of small or large cell cancer she has as you, as her POA, have decided treatment is not an option for her (and I agree with you). Nor does she need to know, if that is your decision (and you know her best). Nor do you, in my own humble opinion.

Sometimes the opinions of others simply adds to confusion. Go with what your gut tells you here. I trust your love for your Mom and your knowledge of who she is and what she would prefer.

In general, and as an RN all my life, I don't believe in hiding diagnosis. I would simply say a spot was seem on her lung and in 6 months doctor would like another scan (which in truth will tell it all). Many people get lung cancer today without having smoked a single cigarette; so grandmother can take "guilt off her plate" with this one.

I am sorry for this probable diagnosis, but agree that treatment will not add to the quality of her life.As a breast cancer survivor (so far) there are worse ways to go than cancer with good hospice medication.. Dementia and ALS for instances.

It is highly unusual today for people to hide diagnosis from patients "for their own good" and my fear is that someone somewhere WILL let the cat out of the bag. You will them be blamed for hiding things from grandmom. I personally would not hide a diagnosis such as this. But as I said, you know your Mom best.
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Adding that general anesthesia can make dementia worse so that should be another reason not to proceed with the biopsy in my opinion. Ask the doctor about that.
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Igloocar Aug 2023
For a needle biopsy, I doubt if a general anesthetic would be necessary. I had an open biopsy, and it wasn't necessary even for that.
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My grandmother was riddled with cancer and didn't know it. They did some x-rays and scans, discovered all the tumors, told her, and she died the next day.

If your mother was a heavy smoker as my grandmother was (though she'd quit several years before), odds are excellent she has cancer. I think the doctor is being ridiculous even suggesting she might NOT have it.

I, too, would skip the biopsy. What kind of treatment would you do even if it wasn't cancer? Surgery? No. So, why do a biopsy?
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sp196902 Aug 2023
I agree I don't get the point of the biopsy even if it is cancer or something else (like really what else could it be? If it's benign or malignant either way it doesn't matter because there will be no surgery). I think the doctor just wants to get paid to do the biopsy. That's my 2 cents on that.
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In pondering why she would need to have any diagnosis of any sort, and since I've not been in your exact shoes, would a specific diagnosis impact insurance coverage or options for any services going forward? Like, is palliative care covered differently if there is a cancer diagnosis as opposed to just "not thriving"? I'm only asking because I don't know and the answer may help others reading this thread.
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ForReal Aug 2023
She said that the doctor told her that a biopsy was necessary to identify and treat in case it was not cancer. The op also said they would not pursue aggressive treatment. That does not mean that there may not need to be less than aggressive treatment.
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What are her symptoms?

Does she generally forget things you've talked about?
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Thanks for the responses so far! I had talked to the Doctor and we agreed that doing the biopsy is a good idea as cancer can not be confirmed without it and who knows maybe its NOT cancer. As well we would know what we are up against and be able to plan carefully for the best kind of life she can live until she dies. No one has mentioned anything about the law yet, but I will bring it up at the biopsy appointment. I just cant stand the idea of her knowing and really believe she would be happier not knowing. She was a heavy smoker all her life and knowing she has lung cancer would just make her feel guilty, ashamed and disappointed in herself. It IS cruel that we tell her!

I am now trying to figure out what to say to her before going to do the biopsy. Maybe I could tell her they saw a spot on her lung and want to check it for infection...and then never talk about the results with the hope the with time she forgets about the biopsy. Any suggestions?
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ventingisback Aug 2023
“It IS cruel that we tell her!”

You know best. Follow your gut. As I said, for me, it would be about guessing what you think your mom would want. And if you guess she would rather not know, then definitely follow her wishes.

(((Hug)))

Yes, you can ask about the law. Some doctors will take the law literally, and tell the diagnosis. Definitely speak with her doctor. I’m sure the doctor will follow what you think is best.
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A very wise geriatrics doctor told me years ago "if you aren't going to do the treatment, don't do the test".

Don't put mom through a biopsy if you aren't going to pursue treatment. Get palliative care for her and then hospice.
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KPWCSC Aug 2023
Exactly what our geriatrician told us. Even the testing can bring unnecessary stress and pain, even side effects and recovery issues. No biopsy, nothing to talk about.

As far as getting her affairs in order, everyone should be (financial, legal etc.) because no one knows when their time will be….her mom may outlive many of us who still think we might live forever.
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Why bother with the biopsy if you are not going to pursue treatment? It seems like putting her through that is pointless too.

With her moderate dementia if you told her would she remember the next day or week?

I disagree with Venting if telling her will create anxiety and stress. Why would you do that to a person?

Adding I am for not doing treatment for cancer on someone with dementia.
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ventingisback Aug 2023
“I disagree with Venting if telling her will create anxiety and stress. Why would you do that to a person?”

I do see what you mean. I think these things are so personal, as in case by case. Like my mom would prefer to know no matter what. But for sure, not everyone is like that.

Regarding the legal perspective, I’ve had doctors tell me, that if imminent, the law is clear: they have a right to know; the doctor has a duty to tell the patient the diagnosis.

Many years ago in some parts of the world, if it would upset the patient, doctors would keep the diagnosis secret from the patient. But laws have changed. Now a patient has the right to say bye and get their affairs in order.
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From a moral perspective:
I think you should guess what your mom would have wanted, if she had a clear mind. Would she have preferred to know, no matter what? I’m the type who prefers to know, no matter what.

From a legal perspective:
The laws now state that if death is imminent due to illness, the patient has a right to know the diagnosis, because they might want to say bye to certain people, or get their affairs in order one last time.
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sp196902 Aug 2023
She has dementia if this would be retained in her memory then telling her would be cruel.

People with dementia don't really have the concept of getting their affairs in order. Do they?
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