Mum likely to refuse treatment. What next?

[Roseformeplease]

My Mum has throat cancer, just above her vocal cords, about 2 inches long. She is 74, an alcoholic and heavy smoker. She has, in the past , refused all medicine, even paracetamol, often claiming allergies. My assumption is that she only wants alcohol and any treatment might interfere with that.

She has been offered 2 options. High dose radiation (recommended) or low dose from longer (less effective). Her alcoholism means surgery is not possible.

She will either refuse treatment, or pretend to go along with it but find excuses not to attend.

What next? Sorry to be blunt but can we make her? I don't want to but others might. How will she die? Starvation? Will she be able to breathe? How do they treat alcoholics, given that withdrawal is not really going to happen without help and she will NOT be away from her booze.

Can someone tell me the worst that will happen? Do we have to watch her commit suicide by cancer? How much support will she get?

I love her and want her to be well but the whole process of dealing with this is making me exhausted. None of her children live near her and she refuses to move. One sister refuses tospeak to her. I am dutiful on the phone but find visiting very difficult as her alcoholism makes her very difficult.

Advice? Support?

Thanks. This is so bloody hard.

(Am away for 2 days so might not get back to this but really hope for some help).

[redshoeblueshoe]

I do not think they can force treatment on her. You know what that means, she will die. Obviously her alcoholism has made her relationships fraught, and it is admirable that you still love her.
I don't know if this is any help, but you are in my thoughts

[totallybewildered]

It shouldn't be a case of "refusing" treatment. it should be a case of discussing the options with the doctor, and choosing the way forward together.

[mineofuselessinformation]

As hard as it is, I think you have to accept whatever your mother decides. Sorry, I know that will not be easy.
If she chooses to discuss it with you, then tell her how you feel. But, otherwise, I don't see what else you can do...
Having lost a close relative recently, knowing that she must have known that she was seriously ill long before she was forced to seek treatment, all I could do was to support her.
I'm so sorry.

[mineofuselessinformation]

And to add, you have every right to re-iterate that her treatment is her choice (not necessarily your choice), but that is what it is.
The imminent death of a family member raises all sorts of conflicts when people hold different beliefs about what someone should do in the face of a terminal illness. But each person needs to recognise that their choices may not be the choice of the person affected, and respect that.
Don't let let anyone make you feel badly about what you have decided to do and feel.

[Roseformeplease]

Thank you all. She is now thinking of listening to the Doctor. However, the implications of treatment and the fact that this will mean loss of booze and fags means I suspect she will not follow through. Sadly, she is very destructive to herself and very deteined.

[ReallyTired]

I am sorry that your mother is so ill. It is a really tough situation for all of you. There are no easy choices for people in their seventies with cancer. Sometimes the treatment kills the person because their bodies cannot cope with the strain.

My neighbour is currently dying of asbestos related lung cancer. He is not that much older than your mother and also has opted only to have palliative care. His logic is that radiation and chemotherapy would not give him much longer to live and he prefers to have quality of life over quantity. He is visited by a nurse daily and medical care is focussed on pain relief rather than prolonging life.

[whatisforteamum]

so sorry about your Mum.i agree with others it isnt easy and her choice at the end of the day.My dad had lots of gruelling treatment for his cancer and was deciding to give it up as he was so ill and tired then he was told the chemo wasnt working and nothing more can be done.He is currently ill again for the 3rd time in 3 weeks.It is so hard to watch your parents suffer.

[SDTGisAnEvilWolefGenius]

My sister and I are Attorneys for our mum, (on her Power of Attorney form), and as part of that, she has made it clear that, if she gets cancer, she does not want to be treated for that, because she feels that the treatments are worse than the illness, and she doesn't want to go through lengthy surgery and recovery, radiotherapy or chemo - and my sister and I respect that decision.

Hard though it is, I think you have to respect your mum's decision - cancer treatment can be horrendously difficult to go through, and for someone of your mum's age, I imagine it would be even harder.

We had to watch my MIL go through this, with pancreatic cancer - she had a major surgery, and was finally getting back to normal after it (this is an operation that very few people recover 100% from), when they found it had spread to her lungs. She had chemo, which was incredibly rough on her, but it didn't work, and in the middle of last year we were told she was terminally ill, and on palliative care.

The hospice were amazing - she was admitted there following a fall, and we hoped that she would be there for a few weeks, until she became ambulatory again, and could manage at home with a bit of help - but this never happened - she remained bed bound and incapable of walking, so the hospice moved heaven and earth to give her what she wanted - to die at home. They set up 24/7, live in care, supported by another carer visiting 4 times a day, and the district nurse coming in to give her medicines, and provided all the equipment needed too.

She was able to have her last weeks at home, with her friends and family visiting, and dh was there with her, when she passed on, which has been a huge comfort to him.

I am so sorry for what is happening to your mother, and I understand how difficult and painful a situation it is.

[Roseformeplease]

Update: my Mum seems to be going along with treatment - turning up for appointments and meeting various Nurses, Drs, Therapists etc. however, she is subtly sabotaging treatment. She had some teeth pulled, on advice from the dentist as they were rotten. She was given antibiotics to sort out an abscess but didn't take them. Hence her radiotherapy has been postponed as she can't have it with a mouth infection.

She is drinking loads and loads, but eating very little. She keeps buying food - her fridge is full of things she might enjoy but she is eating so little she is losing weight fast. She is smoking a lot.

It just seems like she wants to go through the motions, is really enjoying all the attention (from strangers - she tells practically everyone she meets) and yet is probably not going to actually follow instructions, rather like an obstructive child.

It is growing in her throat and she will eventually be unable to swallow, or breathe. She is likely to be offered a feeding tube but "does not fancy" this.

It is hugely frustrating and, while they are all being wonderful, aren't the doctors and nurses going to get fed up and give up on her?

[ImperialBlether]

I'm so sorry. You only have to visit a hospital and see the people hanging around outside, some with drips, so they can have a cigarette, to know how frustrating it must be to be a doctor. However, they will be used to it. You have to accept your mum hasn't long to go, I'm afraid - if she gave up alcohol and tobacco now would it really save her life? I'm not sure whether I'd think it was worth coming off a highly addictive substance at that point in my life, though the thought of not being able to breathe is absolutely horrifying.

It doesn't sound as though she'll make the decision you would make, but she'll probably make the only decision she, as an addict, can make. I'm so sorry you're having to watch her like this.

[Peppasmate]

My mum is a chronic alcoholic & smokes 40 a day. She is also addicted to prescribed pain medication. She's had a number of strokes. How she's alive is beyond me.

My mil was also an alcoholic & very heavy smoker. She was diagnosed with lung cancer 2 years ago. It had already spread to her liver & brain. She refused all treatment. She continued to smoke & drank a bottle of vodka every day when she got out of hospital, even refusing to return for basic biopsy's. She died 5 weeks later. Watching her smoke was hideous. She never drank in front of us.

I decided all I could do is follow her wishes. She was going to die regardless. She was only 68. No health problems & very active.

Her death changed me. I think of her every day. I loved her so much.

With my own mum, I feel as you describe. My mum's very similar in respect to talking the talk but not actually following treatment whilst enjoying all the attention.

My way to cope, is to remind myself she is a grown women, making her choices.

It distressing at times. I'm as detached as possible. It's all so complicated.

This time will pass. She will die. All you can do is do the best you can.

Take care of yourself.

[Roseformeplease]

Thank you all. Am trying to make sure, when I speak to her, or see her, I make it as positive as possible so that we are both left with lasting good memories. But, the restoration of watching her "unable to swallow food" while drinking a litre of vodka for dinner, is awful.

She is having another attempt at the treatment next week so we shall see.

[Roseformeplease]

Update - she has had some radiotherapy! Seems to be doing what Dr wanted her to do. Fingers crossed. Thanks all.