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The Doctors (2) and surgeon (1) tell us this is how to treat her physical condition. They say at her age it’s major surgery. I’m having difficulty understanding why surgery when no medical professional will say she has cancer. Why the major surgery at 82 years old for a can’t rule out cancer reason. Rule it in or rule it out. Why can’t we be certain?

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notgoodenough wrote: "What IS her physical condition? What were the health circumstances that brought her to 3 different doctors for advice on treatment? Because I have to believe this wasn't something found by doing an annual OB/GYN screening at 82 years old.

You say she's mentally unstable - how do you mean? Are you referring to some form of dementia, or a different sort of mental disability? Is she capable of making her own decisions? Or is she not capable, and you/another family member her POA/MPOA?"

Yes! Please give us more information!

I'd also like to know if your mother lives with you? You with her? What kind of caregiving do you do now? Besides full hysterectomy being a big surgery (and recovery!) for an 82-year-old, are you going to be the one to be the caregiving slave during that recovery?
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My mom had a hysterectomy at about 82. She had tested positive for cancer. The surgery nearly killed her as she developed an infection and was hospitalized a couple of days later. She remained in the hospital for two weeks until she was finally strong enough to go home.

It was after the surgery that everyone noticed she had some cognitive problems. Chemobrain is a real thing and is often caused by chemo. General anesthesia is another major risk factor for developing dementa. Two strikes! The confusion was probably there before but we were not as attentive as we were after the surgery.

Did the surgery give her a few more years? Who knows and for what? Eight more years of progressing into the depths of Alzheimer's. Cancer when we are older often progresses very slowly. Would that have been the case? Again, who knows. Knowing the dementia would have become so terribly profound it would have been a better idea to leave the cancer untreated. But, it was mom's decision, she was still considered competent.

And a hysterectomy is considered major surgery. I had one in my 40's and it was tough. Sponges were lost, the vaginal procedure became an incision so the doc could go sponge hunting. Anything could happen....
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I had a total hysterectomy aged 50 for extensive endometriosis. Not laparoscopy stuff, not even vaginal – a abdominal scar several inches long. Don’t just assume that it’s a minor procedure. It’s one more thing to ask questions about.
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My former husbands grandmother had one in her early 90's. She lived another 3-5 years.

She did have cancer, but they were not 100% sure before the surgery.
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If two doctors and a surgeon are recommending hysterectomy and you don't understand why, why would you ask complete strangers on the internet who don't know your mother from Eleanor Roosevelt instead of asking them?
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MargaretMcKen Jun 2022
Oh come now CM, Eleanor Roosevelt doesn't know too many people by now. Very dead.
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Pet Scan. You can be certain.
Second opinion.

When a doctor says: "It could be cancer", they don't know.
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What IS her physical condition? What were the health circumstances that brought her to 3 different doctors for advice on treatment? Because I have to believe this wasn't something found by doing an annual OB/GYN screening at 82 years old.

You say she's mentally unstable - how do you mean? Are you referring to some form of dementia, or a different sort of mental disability? Is she capable of making her own decisions? Or is she not capable, and you/another family member her POA/MPOA?

NOT that I'm advocating for this 82 year old woman to have a full hysterectomy, but there are other reasons besides cancer to have this procedure done. Some background on what her symptoms are might put the question into better perspective.
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Get a second opinion immediately!
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Answering only for myself: if I'm ever 82 years old and mentally unstable, I pray to God that no one will let a doctor perform a surgery that could prolong my life by a decade.

This must be a difficult place for your family to be in. Best wishes as you decide what to do. But do keep in mind that doctors have a financial incentive to push such treatments, and it's not always in the patient's best interest.
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notgoodenough Jun 2022
This might not be a case of cancer. If this 82 year old woman has some other issues causing her pain (fibroids, endometriosis) the recommended surgery might not have anything to do with extending her life, but with relieving her pain. The doctors might not be saying cancer, because cancer might not be the driving factor behind this recommendation of surgery.
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Has there been a endometrial biopsy done? That’s just a procedure at the doctors with no anesthesia requirements.
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First..at ANY age it is major surgery. I don't care if it is done by laparoscope or "old fashioned" way putting someone under anesthesia is major.
Removing any organ from your body is major.
If the doctors are not giving a CLEAR reason
If the doctors are not giving a LOGICAL reason
Why this is being advised then back off..get another opinion.
What harm is there going to be if this woman waits another week, 2 weeks, or 6 months.
the big questions are...
IF there is cancer what is the plan?
Treat? an 82 year old? I don't think that is a wise move.
Don't treat? Great option given the age and mental capacity. But if you don't treat WHY do the surgery to begin with.
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Taking any medical advice about a total hysterectomy from a man is wildly foolish, in my opinion. Whether the man is a doctor or a surgeon or just a man giving his 2 cents on the subject. A man always underplays the importance of 'lady parts' to begin with. I know b/c a man OB GYN delivered my first child, a son, and turned it into THE most horrifying experience of my entire life. And all for nothing. All b/c he wouldn't take the time to put a pillow under my butt when breaking my water. And b/c he did not have the patience or presence of mind to comprehend what a woman was going through emotionally, physically and mentally while giving birth for the first time. He just didn't care. When I had my second child, I chose a woman OB GYN and the experience was 100% different in every way imaginable; a pleasant experience instead of a nightmare.

Your doctors are not giving you ANY answers that you NEED except to say it's 'major surgery' and that this is how it 'must be done.' With no reasons to back up those claims.

I call FOUL.

Either get the correct answers to your questions or find another doctor, and insist it be a woman who's doing the surgery ON your loved one who's a woman herself & needs a hysterectomy, maybe. And insist on knowing where the cancer is, how progressed it is, and if there are any other alternative treatments OTHER than surgery available. And then think long & hard before putting the woman through such a surgery, when she's 'mentally unstable' to begin with. Will extending her life (IF such a thing happens) be worth it? Does she want her life extended? Being mentally unstable, will she be able to endure the recovery process which WILL NOT BE A CAKE WALK, regardless of what man tells you it will be?

Also keep in mind that if cancer is present, there are absolutely NO GUARANTEES of anything, never mind 8-10 years of an extended lifespan! When my birthmother had surgery for uterine cancer, it wound up spreading to her ovaries and KILLING her in short order, rather than 'extending her life'. She would have been better off leaving the uterine cancer ALONE than listening to her doctors telling her how easy-peasy it was to 'just operate' on the uterus and 'remove it all' that way. Yeah, huh? Pure B.S. that turned out to be. All bets are OFF where cancer is concerned, IF cancer is at play here with your loved one.

Please demand ALL the facts before you can make any rational decision.

Best of luck to you.
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Isthisrealyreal Jun 2022
My female doctor referred me and he was the highest rated surgeon in the southwest at the time.

So much for ratings.
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I would start from the fact that the facts aren't adding up for you. There must be a piece missing. At least one oncologist has to be involved here. Ask that oncologist to speak with you one on one (could be on Zoom, could be over the phone, could be in person) to go over the reasoning and recommendations.

If that person isn't available, ask if another medical provider in the oncology office can talk to you, a nurse or a PA. If you don't get anywhere that way, talk with your mother's regular doctor or PCP about a strategy for figuring this out. When you do sit down with someone who can put this together with you, include a friend or a relative in the conversation so that they can take notes.

I can understand your dilemma very well. My father has a tumor in his leg, which was discovered at the end of 2020. We were referred to an expert in orthopedic oncology. She was all for taking it out although she thought it was 50/50 whether it was a cancer or a benign fatty tumor.

He was 92 at the time. I got a second opinion at the university medical center and that orthopedic oncologist said he didn't think it looked like a cancer yet (although it could turn into one at some point) and that he should have regular MRIs to follow it.

This doctor left and we met the new one in April. He did not say anything about cancer. He said definitely not take it out no matter what. I didn't like that (too long to go into why) so I talked to his PCP and she agreed Dad should get another opinion on surgery. That oncologist said without missing a beat that it was cancer. She didn't know how aggressive. She too said not to take it out.

Here I was with one oncologist saying nothing about cancer and another saying he had liposarcoma, each having looked at the same MRI. I was ready to do what I tend to do -- flip my lid and chew out both oncologists. Instead, I got his wonderful PCP involved. I asked her to talk to both oncologists to make sense of this. As it turned out, the ass oncologist at the university does think it's cancer but a low-grade type. He says we should keep an eye on it with MRIs.

I called the assistant to the original oncologist who wanted to take it out right away and asked her if the doctor could look at the series of MRIs done over the last year and a half. She said she would but I haven't heard back from her yet so I'll have to call her this coming week.

I told Dad this was his decision and I went over everything with him. He asked my opinion. I just don't know yet. Once I get the original oncologist's opinion, if I do, I'll drill down on the pros and the cons.I have just enough medical knowledge to be stupid but I'll do the best I can. Then I'll run my rationale past his PCP.

So, if there's time to, come up with a strategy for getting the facts explained to you in a logical way. The missing piece in my father's case was the idiot oncologist at the university. Nothing is 100%, so do the best you can and get any help you need. Best wishes.
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Who is the medical POA and the POA. Given what anesthesia alone can do to an elder, if this can be prevented it should be imho.
What symptoms are your mother having? Does she have a prolapse? Often a vaginal hysterectomy can be done quickly. I would get thorough information about exactly' A) what condition are they dealing with B) what are the repercussions of not having surgery?
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If you mean "unstable mentally" that she has a Dementia, I would not put her thru the surgery. Putting her under will only make her worse. They would have to give me a definite diagnosis before I would allow surgery. What problems is she having that they feel there maybe cancer involved.
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Personally, I would not go through with the surgery. No benefit in living 10 more years mentally unstable and losing it fast. The only ones benefiting from the surgery are the hospital and the doctors.
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I personally would not choose to treat this, cancer or no.

A hysterectomy in an 80+ woman is MAJOR surgery and no fun to recover from.

There is no excuse for a drs not finding a positive cancer DX. Sheesh, a simply PET scan and she'd glow light a Christmas tree! Non invasive and simple.

I'd be really, really hesitant to go with a dr who cannot give a clear dx but is willing to perform this surgery on her.

And, does she WANT 8-10 more years? When/if my cancer comes back, I am not treating. And I'm only 65!
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This is the medical reasoning:
1-The uterus and ovaries are the sites of many types of deadly gynecologic cancer.
2-The uterus and ovaries in an 82 year old woman are useless organs.
3- If there is a suspicion of cancer, it's better to get the uterus and ovaries out without waiting for cancer confirmation, because by that time, it could be too late.
4-In regard to the surgical risk, removal of female reproductive organs can be performed nowadays by laparoscopy surgery, which is a minimally invasive procedure. Very safe, less traumatic and with a short recovery time.
5-In regard to the anesthesia, it could be performed with spinal anesthesia, which avoids general anesthesia.
Not having surgery would allow a potentially treatable cancer, to kill the patient within a short time.
6- A successful surgery would guarantee at least 8-10 additional years in her life span.
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Chlokara Jun 2022
Think very carefully about No. 6. Maybe this is God's way telling you it is time.
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Have they done a biopsy on whatever is looking suspicious in her uterus? Shouldn't that be done first before any type of surgery is done or even talked about? I would most definitely get a second and even third opinion, as someone at the age of 82 undergoing surgery, and with the mental issues she already has can be quite devastating, as the anesthesia itself can cause lasting dementia type symptoms.
You have to do what you feel is best for her. I wish you the very best in figuring out exactly what that is.
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Are you talking to the doctors directly or is the info coming through your mother? I'm asking because if it's coming through your mother she may not be remembering it correctly or she may be hiding her true diagnosis. Did she have a biopsy? Have you asked them why they are having trouble knowing what her diagnosis actually is?

Are you your mother's PoA? Or legal guardian? At 82, that is a very major surgery for sure. Even the after effects of the anesthesia, and UTIs from being catheterized will add to her recover burden. Do you think she will willingly comply with her post-surgery self-care? If not, then maybe consider other options, like hospice. More information would be very helpful so that the many seasoned RNs on this site can provide you with the best guidance.
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