Older Women

Hi, my 77 year old Mum was diagnosed with secondaries back in August. She first had BC with a few affected lymph nodes 9 years ago, had 2 ops, radio and chemo and all was well. This diagnosis has knocked us all for six! Her breasts were completely unaffected this time but she had affected lymph nodes (we don’t know how many were affected) and subsequent CT scan revealed that she has a very tiny affected area on her liver and what the hospital calls “a bit of a problem” in her chest (they did not use the word “lung”).

Quite apart from the total shock of all this, my brother, sister and I don’t feel we know the full story. Like a lot of older people, I don’t think our parents ask for the amount of detail we would ask for, maybe because their generation considered the medical profession to be “the experts” and the patients were just expected to follow their instructions. Also, there is the shock factor to take into account. Did they not ask because they were in shock (they get a bit defensive when asked)?

Looking at these discussion forums, I see that many of you are very well informed about your condition, treatments, drug types etc. But we don’t know how serious this is. The oncologist told her which type of chemo she is having (starting tomorrow) but he made that decision before she had even had the CT scan and today she had a bone scan and she’s still supposed to be having chemo tomorrow! We don’t understand on what basis they have made the decision about her treatment, before all the results were even in!

As her (grown up) children, I don’t know if we have any right to go to the hospital asking for more information, as my parents have both been attending the appointments together and we have only been informed at second hand.

We’re feeling anxious and a bit low and worried that hospital might not be taking much trouble over Mum because she is “old”. However, she might be 77 but she’s not an “old lady”. She’s healthy and active and has all her mental faculties. She is not ready to go and we are not ready to lose her!

Hi there
it’s always hard being ‘grown up children’, I’ve been both sides. It can be very difficult not to become the parent and take over - asking questions that concern us, but not them. Not giving them space or the confidence to ask their own questions - or not ask them.
Some people really don’t want to know. Some people want to keep it private. Just because they are our parents we don’t have the right to pry, same as we don’t have the right to know everything about our adult children.
You say your father is there with her, trust him to protect her and support her. I know it is hard, and you are worried, but I think you need to let your parents be the adults that they are. Just because they are old doesn’t mean they are incapable.
It is good they are starting treatment so soon - maybe it seems strange to be starting before they have all the scans but, with chemo costing such huge amounts, i am certain they have enough information to start it. Maybe these other scans are to work out what other treatments they can use?
As to being well informed, it’s a steep learning curve for us all. this site provides some great resources and i’d suggest you order the primary resource pack for your Mum and use it as a starting point.
When my father was ill and kept things to himself, i had to ask myself if i would want to tell my daughters every little detail? the answer was no, and still is no. Doesn’t make me daft, just me needing time to get my head around things before everyone asks questions.
i know it is worrying, but things will get easier
take care
Ruth x

Hi Psyche

Firstly I’m so sorry that your mum is having to go through this at all - and that you’re having to watch her do so. A close family member of ours, of similar age to your mum, has another kind of cancer and I can share our experience with you in the hope that it may help. Also I had a diagnosis of breast cancer this year and have had to learn very quickly how the medical team works.

We had great difficulty getting information from the relative about her illness. In particular it wasn’t clear whether the information gap was because she knew something she wasn’t telling us, or because she’d not asked the questions at all. We too had considerable concerns that she might not be getting the best treatment because of her age. She and her
partner dealt with it all with very dark humour and we found that this shut us out - the topic just wasn’t up for discussion. We were very scared for her and didn’t know what we should do, nor what to say. Eventually, of course, all the bottling up of emotions on both sides came to a head and there were emotional outbursts before we finally started talking properly. We now go with her to some oncology appointments. However, and this is very important, the medical staff will not talk to us directly - our role is as supporters and while this is bloody frustrating at times it is of course as it should be. What we now know is that the medical staff don’t hold back at all from telling her everything about her diagnosis and treatment, but she can be very selective in what she then relays to us. Whether this is because she doesn’t take in everything that she’s been told or because she wants to spare us some of the information is not clear… It’s taken us a while to reach the point we’re at now - of respecting her right to decide what to talk to us about. The trouble is that it’s so frustrating - we can see she’s suffering and she won’t let us in. We also, to put it bluntly, don’t know how long we’ll have her with us and that’s very, very hard.

Breast cancer is now dealt with in multi disciplinary teams comprising oncologists, surgeons, radiologists, breast care nurses and other professionals - that’s possibly a change since your mum’s original diagnosis. I had not initially understood this and therefore felt very out of control when I saw e.g., the surgeon who talked about chemo or the oncologist who talked about the surgery i would be having. Knowing that they work as a team is actually very reassuring.

I was told that i was being prescribed a particularly aggressive chemo regime because I was a younger woman and because of the type of cancer which I had. My understanding of that is that a) a younger body was better able to withstand significant side effects (including heart damage and sclerosis of the veins), and b) a high grade cancer needed to be blasted, whatever else it did to my body. You don’t know the detail of your mum’s diagnosis nor the treatment offered - these are issues you could ask her to tell you and you could then talk to staff at the BCC helpline who could give you general info.

Re the tests which are still outstanding, the oncologist already had information about the stage and grading of the cancer to decide on the chemo regime , my understanding is that the CT and bone scans will be to help to decide further treatment if required.

I thoroughly recommend Dr Rob Buckman’s book “Cancer is a word, not a sentence”. It’s intended as a guide to people who’ve recently been diagnosed with cancer, but I’ve found it really helpful not just in coping with my own illness, but also with how to communicate with our relative. It has a section on communication strategies and the whole book is a brilliant resource, explaining how diagnosis and treatment work as well as coping with some very complex emotions which are an inevitability it seems once cancer is part of our lives.

I do hope some of this helps you. if it’s any comfort to you, you sound like a wonderful daughter. You’re a bit older and wiser than you were last time your mum went through this - tell her how you feel and I hope you resolve those issues.

Sarah
XXX

Hi. I’m a secondaries patient. It sounds as though your Mum is being offered the very same treatment any younger patient would have. As she has liver involvement chemotherapy is a pro active treatment option. If she does have bone metastases she might be offered bisphosphonates to strengthen her bones. I’ve had bisphosphonate treatments since early 2004 with no side effects. I wondered if your Mum had Tamoxifen or Arimidex after her primary diagnosis? If her breast cancer is er+ there are other hormonal treatments like these she might be offered after chemo.
If your Mum hasn’t already been allocated a Macmillan nurse her GP can arrange this, she may find it easier to ask any questions or discuss any fears with a Macmillan nurse in her own home rather than a hospital setting.
I wish her well with her treatments.

Although I am not as old as your Mum I have two children 38/36 both married with families and I tell them as much as I can and OH does the rest. I must reassure you that age doesn’t make any difference to treatment when I am having chemo there are many people there in 70s.

The treatment is decided on the different types of BC (there are many different types) you have and on your general health etc so everyone is different ‘young’ people do not get better/stronger treatment it is the type of BC. Rest assured your Mum will be well looked after. She is prob in a bit of shock at the mo and will get round to having a good chat with you and maybe if she finds it difficult to get the answers re her actual BC perhaps you could help her make a list of questions to ask… there should be a BC nurse available ans usually the area has a cancer charity which has all sorts of info and some complementary therapies available… just take it slowly as it all takes a while to take it in.

Hi everybody, thanks so much for your kind and really helpful comments and advice.

My sister, brother and I are reacting more calmly this time round than we did 9 years ago but inside, are just as churned up. We don’t talk about it with each, just stick to factual stuff about what her treatment will be and when and try to be as supportive as possible to both our parents by being “normal” when we speak on the phone and spending time with them (not so easy because we live 60 miles away from them).

I’d like to get this off my chest. I work with a group of men in their 50s. One of them overheard me telling somebody what was happening with Mum and then asked what was up. When I told him, all he could ask was the standard question that I’ve come to expect from people “how old is she?”, as though it doesn’t matter if she has cancer because she’s old. Well, to me, he’s old (he’s nearly 60) but I don’t feel like he’s approaching his deathbed!

He has not mentioned it since, never asking how my Mum is or how I am or anything. With another of them, a bit of a know-all, he asked how Mum was doing the other day and when I said that her oncologist had said the cancers were probably slow-growing, Mr Know-All came out with “well, that’s not a good thing actually as chemotherapy doesn’t actually work on slow-growing cancer cells”.

I know that we are only workmates, not real “friends” and I know that people have different ways of reacting to things but I feel deeply hurt by these two, especially the lack of sensitivity of the second. We’ve worked together for several years and I thought I might get a little more support than that from them.

Hope you don’t mind me offloading this.

Psyche

Dear Psyche
It’s usually because they don’t know what to say. If they would only tell you that, you could then reassure them. Instead they feel they have to fill the awkward silence and that’s where the Mr KAs of this world can cause real damage. Just what you don’t need.
My version of it is the number of people who want to discuss how I’ve caused my cancer - have I had too much stress/ food/alcohol? There are times that such people are extremely fortunate to get away from me before I start screaming!
Sarah
XXX

Hi rareybird,

It’s incredible that people would do something like that i.e. discussing how “you” have caused your cancer! I can empathise with you wanting to scream at them. People can be really strange at these times. You certainly find out a lot about people you thought you knew at times like these.

On the plus side, my boss at work, who I’ve never had much time for, has turned out to be tremendously compassionate and understanding. Again, I’ve found out something about somebody and I won’t be so quick to write him off now.

All the best for your recovery.

Psyche
xxx