Would a Dr lie about treament options?

[rosenylund]

My uncle had most of his bowel removed due to cancer about six weeks ago. My mum has a long difficult love/hate relationship with my aunt. Today he had his update and has been told the cancer hasn't spread and that he won't be having chemo.

My mum said this is suspicious and she doesn't believe it, and that doctors lie sometimes when they don't believe the patient is fit enough to carry on treatment.

I queried this and she went mental, how I'm doubting her etc when she's been a nurse for 40 years etc. etc.

I just can't believe the hospital would lie to him - before he got ill, he was a fit 75 year old, non smoker etc. He's obviously knocked for six after the surgery but he's recovering. He just doesn't fit this idea of someone too emotionally frail and physically frail to take the truth. My parents (both nurses) believe the cancer has spread or is still there, and the Dr has deliberately decided to halt any further treatment.

Parents now not speaking to me as I challenged their knowledge apparently. I should add that my mum frequently has issues with my aunt verging on the paranoid and I think this is some kind of extension of this. She has on a number of occasions taken off on my sister and I for 'not believing' her when she raises issues about her sister. She worries about her sister constantly but it often comes out in anger towards my aunt.

The truth is it's so tiresome, and some of her beefs are so out there, we don't tend to comment or commit - we can't, we don't agree and its often easier to say nothing.

Difficult time at the moment as it is, so this is just another thing to deal with. I must add that during this conversation I was reasonable and measured, which prob. wound her up even more. She started ranting about how my sis and I don't support her - again totally unrelated to the original conversation.

I'll also add that my parents have come to this conclusion following a phone conversation update with my aunt after the consultant appointment yesterday, and are both raging at me for my question as to why they believe all this.

Just to clarify my uncle is my aunts ex partner, but they have always stayed close and he's staying with her whilst he recovers. There's been all kinds of anger from my mum about him and I think this is all tied up in that really.

Very tired and fed up now.

[dogscatsandbabies]

So, this is just what your aunt told your mum?? Could it be that chemo was discussed as an option, your uncle has turned it down and he doesn't want your mum to know because if this sort of reaction?? Some people just decide it's not for them.

I seriously doubt a doctor would out and out lie to a patient about this. I know plenty of them and they wouldn't dream of it.

[rosenylund]

My thoughts exactly, what with informed consent and everything. We were all expecting chemo, even my uncle.

To add some more info, he adopted a child 8 years ago whom he adores, and it changed his life - I just don't think he would refuse if it was offered in order to be there until his son hits at least 18.

Yes, it's what my aunt has told my mum, called up happy to say he's clear and no spreading of the cancer. My mum has inferred that the drs have lied from this conversation.

[LadyRubyPenhaligon]

But if the cancer had not spread into the lymph nodes (which would have been removed for testing) then there would be no reason for chemotherapy.

[dragonflyinthelillies]

It's entirely possible that the surgery has removed all the cancer and he doesn't need any chemo.

Not all cancers need/respond to chemotherapy and surgery can be an entirely successful treatment on its own.

Hoping this is the answer

[rosenylund]

Exactly my thoughts - if it had, surely they would have given him the options?

As I said earlier I think is all bizarrely tied in to my mums feelings about my aunt.

I'm the devil now apparently, she has also said I shouted and raised my voice - in fact I was just tired of it and did no such thing, and when she started ranting I just said I'll go now. I can't support her paranoia about my aunt as I just don't believe some of the things mum reads into my aunts behavior.

[firesidechat]

My husband has had cancer off and on for 6 years. He has never had chemo. Chemo is only given in specific circumstances when there is a possibility of spread. Your uncle has had the cancer removed and presumably a scan to check for spread as well.

Quite frankly your mum is being ridiculous and if anyone behaved like this around my husband I would not be responsible for my actions.

[NoMarymary]

No they are not allowed to lie, even if asked by a spouse to do so. They can omit information but if asked directly they must tell the truth.

Unless the aunt is lying about his ongoing treatment what you've heard is probably true.

Bowel cancer can be confined within the walls of the intestine and can be removed completely. They would have tested some of the nearby lymph glands and if they were clear then there is no need for chemo or for radiotherapy. Simply put all traces if the cancer have been removed (I think it's called stage 1 where it's not spread) so there is no point in further treatment.

Ps your mother sounds a bit odd

[raltheraffe]

Chemo in bowel cancer has only a modest effect on survival statistics. I have not practised for nearly a decade, but back then it was a 7% increase in survival in a Dukes stage C. Might have got better than that now.

In my experience I have never seen a doctor tell an out an out lie, but some can be economical with the facts. When we did breaking bad news at medical school we were taught to be very very frank when someone was terminal, as people do not take in bad news easily and so unless you are very clear in what you say they can go away still thinking there is a chance of survival.

[Becca19962014]

The same thing happened with a family member of mine, almost exactly what you have written OP.

My uncle had decided to not have the treatment offered but had told everyone he was fine. He had not given up, if you knew my uncle you'd know there was no way he would do that, but had been told clearly it would not save his life, it might prolong it but he didn't want that.

He always saw his doctor alone. My aunt was not allowed in the appointments and the doctor never spoke to family at all as that was his wish. So he told my aunt the doctor said x and she then told everyone else when in reality the doctor had said y instead.

I'm not saying this is the situation with your uncle, but it may be worth considering. I honestly hope this isnt the case because it tore my family apart. I had realised what was going on quite early as what he was saying didn't add up for me - my best friends mum had died of cancer shortly before this happened. I tried to speak to him but he just blanked the subject as did the rest of the family.

After he died my family pursued a case against the hospital accusing them of refusing my uncle treatment, that was how it came to light it was his decision.

[FrancesNiadova]

I don't think that the Dr would lie. The cancer Dr s are truly committed & just driven by saving life.
I had to have a mastectomy because of breast cancer. Thank G, it hadn't spread into lymph nodes; they caught it early. So, a big mx op, (9.5 hrs in surgery followed by 24 hrs HDU), but no chemo whatsoever. How lucky was I!
Perhaps over-dramatising things is your Mum's way of coping & trying to make sense of a situation that she doesn't really understand anymore?
I hope that your Uncle has a clear future diagnosis now & has good health in future.

[KnackeredMuchly]

I have the same mother. She sounds very stressed and highly strung at the minute, when mine gets like that I see no point in arguing about rationale with her. Leave her in her delusions for a little while without challenging her, when time has passed you can offer up snippets of truth that help show her it is not all doom

[rosenylund]

Thanks for these comments - exactly what I think. My parents can be quite difficult with medical stuff as they often feel they know best having had such long medical careers.

My uncle is pretty deaf as well so aunt goes to all appointments with him, she was defo there.

Rang mum she was out, spoke to my dad who says i was disrespectful and how they've seen all this before, almost certain cancer is still there blah blah blah - no talking to them apparently!

[PacificDogwood]

Doctors do not lie to patients deliberately to mislead them.

What has your uncle said?

Cancer treatment is protocol driven - your uncles histology (examination of the removed bowel/lymphnodes/whatever else was taken) and type of cancer will determine what further treatment is required.

Bowel Ca is classified in Duke A, Duke B etc categories depending on spread and Duke A does not require any further treatment, nor does some Duke B.

It is my impression that this is more to do with whatever is going on within your family dynamics rather than poor communication.

[rosenylund]

NoMarymary - you're right - Mum is odd when it comes to my aunt; they had a very hard life growing up. Mum is the oldest and always has felt she is responsible for aunt's decisions in life - she just can't let go. There is always an underlying tension between them, although aunt is much better at keeping it under control and just acting normal! I would need pages and pages to recount the issues between them and my mums weird paranoia.

I love them both more than anything but my sis and I have worked out the best way is just to say nothing - which can infuriate my mum even more - can't win!

[rosenylund]

PacificDogwood uncle is stage 3, apparently as we understand it it was in the bowel wall, now removed.

This is defo all to do with my mums innate feelings towards my aunt.

I can't make her understand that I can't support or agree with her sometimes insane ideas because I don't agree!

[PacificDogwood]

I am not an expert and have no real idea what stage 3 means/entails, sorry.

People cope with bad news differently and yes, you and you sister may just have to let this go wrt how your mother deals with it.

V difficult for all of you.
I hope your uncle will be ok.

[Honsandrevels]

I believe it was common maybe in the 30s, 40s, 50s for patients not to be told if they had cancer.

My nanna is 90 and had a breast lump investigated last year. She told the dr that she didn't want to be told if it was cancer and the dr said it didn't work like that anymore.

[raltheraffe]

As Pacific says Dukes staging is in letters from A (good prognosis) to D (poor prognosis). The letters denote how far it has spread. Dukes C is when it has got to lymph nodes and D is when it has spread further than that.

The Americans split it into stages one-four so perhaps the doctor is using that classification, but I do not know much about that. Every colorectal surgeon I have ever worked with uses Dukes.

[Longdistance]

My DM had bowel cancer. She had polyps removed through surgery. She didn't have chemo. It then unfortunately spread to her liver, and she had half it removed, still no chemo. The third time, she had shadows on her liver, and these were burnt out, and then she was offered chemo. This was 6 years ago, and she's still here, stronger than ever :)

[ALittleFaith]

Tricky one...I can understand your parents' concerns but their reaction towards you is extreme and entitled! How very dare you question what you say?

Can you talk to your aunt? I reckon you'd get a clearer idea of what's going on. As a nurse, I can't imagine medics lying about treatment options! They will sometimes emphasise the treatment option they think is best though. I guess it's possible your uncle and aunt are shielding your family but the most likely thing is simply that they're telling the truth.

[raltheraffe]

My gran had acute myeloid leukaemia in 1983. She was terminal. They told my mum but never told her. She knew she had AML but no-one told her she was going to die. She heard it from my mum in the end, not the doctor.

I know of a young lady who is dying at the moment who also claims the doctor never told her and she heard it off the ward clerk. I wonder if the doctor had attempted to tell her, but failed to point it out clearly enough.

It is also very tough for a doctor breaking bad news and some flower up their words with medical jargon and never make it clear enough.

[rosenylund]

Thanks so much for all these replies, it's just so hard to know what to say. I think the only thing I can do is wait for mum to calm down.

Both parents have a long career as nurses, and this often clouds any judgement of medical issues they or anyone else has!

Uncle is struggling with the bag at the moment, but has been told it can be reversed later which is good news.

[MammaTJ]

As a student nurse, I cannot think of any circumstance where a doctor would lie to a patient.

I know that they may not give the full truth sometimes, like when my MIL was dying of stomach cancer, they did not directly tell her, but they did say that she would not get better.

They did not say she was better and did not need further treatment!
No lies involved!

I know that honesty is a huge part of the code of conduct for nurses and I am sure Doctors have a similar requirement, they will not lie!

[whatever5]

No the Dr wouldn't lie. How old are your parents? I think your mother may not have realised that times have changed.

[PacificDogwood]

Yy, times have changed beyond recognition.

There is a difference between lying or deliberately withholding the truth and offering, then giving as much information as the patient wishes.
"Mr Smith, there's a shadow on your chest XR." - "Is it cancer?" will elicit a different answer from me than "What does that mean?" or "I don't want to hear more - speak to my son".