MiL has bone cancer

[elsa12]

Hi,
My MiL has had a fall and taken to hospital where doctors found her hip broken as well as possibly bone cancer (90%chance). She’s been in hospital for a week now and the results are still to come back, so in the meantime, as she can’t be moved about due to broken hip, she developed a pressure sore too. Doctors are already hinting that if results come back confirming bone cancer then hip op would not be possible.
I feel quite frustrated as it feels things not going too swift (a week gone since her fall and still no better informed as to what’s happening to her) and now her pressure sore making it even worse. I’m planning on taking the NHS results to a private clinic for second opinion but not sure how it works as I never had to deal with anything like that.
Could anyone give me advice on how these things happen? Would be grateful for any advice! Thank you

I'm sorry about your mother in law. What do you mean by a second opinion? About having the operation? Or the diagnosis?

What I meant by second opinion is that the doctors are saying they might not be able to operate on her hip due to the cancer. If that will be the case i am worried my mil will end up bed bound at the age of 70! That’s why I would like to see other specialist: to see if they have any other options..
To be perfectly honest I don’t have the slightest idea what’s what but I feel really upset about the prospect of ‘not having a fix’..

Is she being moved (gently) to ease the pressure sores ? And she should be on a pressure mattress.

I'm surprised that you haven't had any results yet and she's been admitted for a week with a broken hip etc. Usually when you're admitted to hospital results for tests come back quickly, especially when the chance of her having the operation and the fact she has bed sores. First and foremost I would be chasing those results up so you know exactly what you're dealing with.

This probably isn’t what you want to hear but once it’s got into the bones the prognosis is very bad.

My mum is 70 and is terminally ill with cancer - she had been in and out of hospital with anaemia and they couldn’t find out what was causing it so did a ct scan and found cancer in her spine, liver and bones. She was discharged from hospital with a lot of morphine and basically given weeks to live.

She has been virtually bedbound in the last couple of weeks, the cancer in her spine and bones is inoperable. There were no treatment options.

I would contact McMillan cancer support and concentrate on options for comfort and pain management.

I’m sorry.

I'm so sorry but if she has bone cancer then the prognosis is not good. They won't operate because it sadly won't help. You need to push for more answers.

I meant to add- they may be able to offer radiotherapy to help with pain relief and slow down the growth, but it won’t be a cure.

I think that the main thing to find out is if the bone cancer is a primary or secondary tumour. Even if it’s a secondary tumour if it’s the only place the cancer has spread to there’s a lot they can do to control it especially if it’s a hormone driven cancer or has a targetable mutation.

The questions I would want to know are:

Is this the primary or secondary tumour?

If secondary, where has it originated from?

If secondary has it spread elsewhere and if you don’t know what tests will you do to find that out?

What treatments are there for the cancer, secondary cancer, especially secondary Gynae cancers can often be controlled for a good period of time

What is your MIL general health like and is she well enough to have other treatment or would it mke her more ill?

Sorry you are dealing with this

VictoriaBun, they tried moving her gently over to other side I think (sorry I’m not actually down there where she is hospitalised, only getting the news from my partner and his brother) but as her hip is broken, she was in so much pain even with extra pain relief that they had to move her back onto the pressure sore area as that’s the only bearable position for her.
hannah1992: I feel the same that things are not moving fast enough and it’s just getting worse.. I think my partner will try to push things but i think they are way over stretched in hospitals as they are and that is also a reason why I’m planning on seeing private specialist.
Fairylea: I am really sorry that you’re mum is going through this, it must be so so hard for all of you! I hope she’s not in too much pain!
I don’t know anything about cancer but aware that if it is spread over the body it will be impossible to do anything about it. What I’m really upset about is the possibility that my mil has to spend her days till the end not even being able to move about, just lie in bed(?!) due to being in so much pain from her broken hip. And then she’ll end up with more pressure sores which will add more pain again..

@elsa12

You need to push hard for the very best pressure relieving mattress / bed that they have.

Personally, I wouldn't bother with the private opinion, as, its likely you'll pay for the opinion of somebody from the same hospital that she's in now - It actually irks me that people assume private is better, when, in fact for stuff like this, they may well be less well equipped to deal with it, and if they did would cost probably in excess of £50,000, which the NHS would provide if it was appropriate.

The main issue is that you can't really operate until you have a fair idea what the tumour is, you can turn a curable tumour into an incurable one by doing the wrong operation at the wrong time, and some cancers that spread to bone can cause fatal bleeding if you operate on them unprepared for the fact.

I don’t know anything about cancer but aware that if it is spread over the body it will be impossible to do anything about it.

Depending on her general overall health that isn’t necessarily true. Whilst they are unlikely to cure it they can often control it and give her a good quality of life for an extended period of time

It doesn't feel reasonable to force her to live for any length of time with an unstable fracture.

Could you go down and ask for a face to face meeting with the team caring for her so you have some clearer information?

Had MIL been feeling generally unwell before the fall? Or had she been less mobile than usual?

A week is a very short space of time for a new pressure sore to form - especially with the air mattresses available in hospital nowadays.

Of course, in a patient in her 60’s, a broken hip would almost always be operated on. But, the cancer does complicate things.

For example, I’m afraid by the time my DDad fell & ended up in hospital off his feet, unable to weight bear, the secondary tumours in his right hip & compressing his spine meant that surgery would not have been appropriate. It would not have helped him get back on his feet. He was 64.

I’m not saying things will be the same for your MIL - of course not - but it may help to explain why the medical team need to get a full picture before deciding what to do next.

If hip surgery is appropriate, she will be offered it on the NHS. The last thing anyone will want to do is leave somebody bed bound when there is another option (I work on an acute medical ward for ladies aged 65+). Remobilising patients wherever possible is always a priority.

There is little point in a private second opinion. They won’t give you an appointment to discuss someone else and it’s likely to be same surgeons anyway. The opinion has to be multidisciplinary to get best outcomes but that often doesn’t happen in private hospitals.

A week is a long time. Hips should be treated surgically within 24 hours of injury usually. I assume they saw bone mets on X-ray. Why so long for a definite diagnosis? Bone metastasis often cause fractures but are usually treated surgically or with cement. Ask what they are waiting for. Ask for the treatment plan. The longer that people are in bed the harder to regain mobility.

People can live for years with bone mets. What is oncologist saying? It is not necessarily an indication that death is imminent.

There should be an alternating air pressure relieving mattress used. Is this in place? Ask for a visit from tissue viability nurse to advise.