OT: getting frustrated with drs in re: to my mom over her lump

[Holly IN]

My mom found a lump near her armpit that is painful. They did a mamogram and something showed up but nothing that concerned the dr's. So they scheduled this test 3 weeks later which was yesterday. Now they said she needs to get a biopsy done next Tuesday. She is 62.

 

My frustration is that they are not in a hurry to see what this lump is. They are taking their time in my opinion. My friend found a lump in her breast and they got her tested right away with a biopsy the next day. She is 43.

 

This sounds like to me that they are not as aggressive in finding out for an older person. This is scary to me if this is the case of letting the old die and save the young. My dh said that they are doing this because her survival rate for cancer will be slim. He said this is the sign of euthenasia is alive and well in this country with our blinders on.

 

I told mom that I wanted to be there with her when she talks to the dr. I would have really talked to him and question the delay in getting the biopsy done. She didn't want me there. She is way too trusting of drs.

 

Does this sound right to you? Do you know of anybody that is my mom's age that had aggressive schedule of finding out what the lump is? I am really upset about this.

 

There is a big difference in my mom's care and my friend's care. Both are going to Methodist Hospital (the same hospital).

 

Also there is no cancer in my mom's side family. It is all heart disease.

 

Holly

[Jennifer3141]

Breast cancer in younger women is often more aggressive.

 

Getting all this testing done in less than a month seems pretty quick, IMO. But of course if your mother isn't satisfied with her care, she should look elsewhere.

 

Jen

[Sara R]

I can't compare the specifics of your mom's situation to young people's situation, but I can tell you that cancer is usually much less aggressive in older people. Young people's cancer is more aggressive and has lower survival rates. It could be that the hospital is divvying out appointments according to the perceived need, like an emergency room does.

 

Also, I wouldn't throw around words like "euthanasia" so casually. Allowing nature to take its course, or not receiving expensive medical treatment (which more and more of us might have to do as our country's wealth evaporates) is not the same thing as actively killing people. The facts are that everyone does die eventually, not at age 62 certainly. But my beloved 85-year-old grandmother got a quintuple bypass (probably covered by Medicare). I'm really glad she's still around, but I can't help but think that heroic medical care like that is part of why Medicare expenses are so high and why our national debt is going to crush this country (which it was already going to do before we started adding all of these bailouts to the list). I don't see how anyone compassionate can make decisions like that, but unless some changes are made, the debt is going to destroy our and our children's generation.

 

A month seems pretty quick to me, too. They say that whatever cancer is there has been there for 10 years. I don't know if I believe that in my situation (no palpable lump in August; golf-ball sized palpable lump in October), but that's what the doctors say. Those stats probably apply especially to older people, who are better represented in the research studies than young people.

Edited December 11, 2008 by Sara R

[Laura Corin]

But my beloved 85-year-old grandmother got a quintuple bypass (probably covered by Medicare). I'm really glad she's still around, but I can't help but think that heroic medical care like that is part of why Medicare expenses are so high and why our national debt is going to crush this country (which it was already going to do before we started adding all of these bailouts to the list). I don't see how anyone compassionate can make decisions like that, but unless some changes are made, the debt is going to destroy our and our children's generation.

 

My father in law had a heart valve replaced when he was in his eighties. The medical community just assumed that he would want it done, and he was a good patient and did what he was told. I'm pretty sure that, had anyone sat down with him and asked him what he wanted, he would have refused the operation.

 

Laura

[LinRTX]

Just to reassure you: I just went through this less than a week ago. My doctor said that 90% of the time a painful lump is not breast cancer, but a cyst. I'm surprised that they did not do a sonogram instead of or in addition to the mammagram. From what I understand the sonogram is much better at determining if the lump is a cyst and not anything more serious. Maybe they are being slow because it is more of a precaution?

 

Linda

[Jennifer3141]

Laura, I think that's really true about a lot of people.

 

My 76 year old aunt had type 1 diabetes for about 40 years. When she entered the hospital for the last time with CHF, she had a very young doctor come into the room and discuss her treatment plan. He was shocked when she requested no intervention and just wanted comfort meds. He was shocked and pleasantly surprised to deal with someone who had accepted it was time.

 

My DH came home one day a couple of years ago after he treated an elderly woman for several hours in the ICU. He said that at some point he had to tell her that there was nothing more they could for her that wouldn't involve more pain than her body would be able to tolerate. She was totally shocked that she was going to die. It was like the idea hadn't occurred to her yet. She was 98. She had no plan. No will. And a family squabbling over her stuff before she was dead, right in front of her. Had I been her, I'd have left detailed instructions to write that whole greedy bunch right out of everything I owned.

 

I volunteer with our hospice program but by the time I become involved in most people's lives, they've found some measure of acceptance. My heart goes out to people who live in fear of their deaths.

 

Jen

[Nestof3]

I had a cyst removed from near my armpit a few years ago. I went to the dermatologist who cut it out and sent it off for a biopsy. I just assumed it was a cyst because of the feel of it -- a hard round ball.

 

Believe it or not, your mom's timetable for those sorts of tests does seem about normal from my experience.

[Danestress]

She would not get the biopsy until I had taken my bar exam - which was more than a month. I only realized later that was what she was waiting for - at the time I was just frustrated that she was dragging her feet, but her doctors were fine with this. I was furious with them for letting her wait, but apparently it did her no harm. Then after they found out it was cancer, she waited a month to have the lymph node biopsy because her doctor was away for a month of mission work. Again, this was fine with her doctors.

 

She ended up having radiation treatment after a lumpectomy. She's been cancer free for seven years now.

 

I think post menopausal breast cancer is often much less aggressive than the kind that women get when they are younger. And based on what they saw in your mother's mammogram, the doctors aren't even thinking it's cancer.

 

However, if your instincts are telling you to be aggressive and force this issue, then do it. Just don't do it with an attitude that her doctors are trying to kill her off because that's surely not the case. 62 is not old by the standards of anyone I know over 35, lol.

 

Incidentally, I would have liked to have gone with my mother to her appointment with the oncologist, but she didn't want that. Most women your mother's age are going to feel fully capable of handling medical problems without assitance from their children. It was hard for me, and I hope your Mom includes you because it does just feel better to be part of the loop. But don't be surprised if she won't do that - especially if she suspects your are critical and doubting of her doctors.

Edited December 11, 2008 by Danestress

[MKS]

Just to throw this out there...

 

post-menopausal breast cancer is much less agressive because the vast majority of breast cancers feed on estrogen.

 

And, yes, if it's painful, there's a much greater chance that it's a cyst.

 

So there is much reason to stay positive about your mom's situation.

[BizyPenguin]

From what I've read and heard bc is much more aggressive in younger women. I still wouldn't have wanted to wait 3 weeks for a test after finding a painful lump regardless of my age. Incidentally I just blogged today about breast cancer awareness and the importance of early detection and mammograms. I will pray that your mom is just fine. God's peace!

[Holly IN]

Ok I nailed mom yesterday to give me answers.

 

The dr said that it is mainly calcium deposit that is causing this lump. They said that her prognosis is very good and will need chemo if this biopsy shows cancer. They do not forsee that. (I do not know why they think this as this is very unusual for me to hear this). Now this next Tuesday is NOT the biopsy appt. It is the appt with the dr and then they will schedule the biopsy. :glare: I told mom that she needs to push the dr to schedule the biopsy that week which is next week.

 

So there you go...More answers but yet more questions as to why the delay of the biopsy...GGGRRRRR!!!

 

Holly

[Kathy in MD]

Breast cancer is often more aggressive in younger women than it is in older women. However even a delay of a few months in younger women is typically not a problem. One of my sister's and I had aggressive breast cancer in our 30's, yet the delays of over 2 months in both cases prior to either our lumpectomy and masectomy were not a problem. So I wouldn't worry about the scheduling of your mother's biopsy.

 

BUT!!!!!!!! If she notices that the lump is noticably getting larger, have her call her doctor IMMEDIATELY!!!! If he doesn't try to squeeze her in, then she should look for a fast second opinion. It could be just a cyst, but it could also be cancer. A second sister (30 years old) had a noticable increase in her lump within 2 weeks and her doctor blew her off for two more weeks. Her cancer was ultra, ultra-agressive.

 

But my second sister's experience with her lump was unusual. So I wouldn't consider the delay for your mother as being "euthanesia", it's just the experience of decades of research in treating breast cancer. After all, in the decades prior to my diagnosis, doctors were prepared to do a full, radical masectomy during the biopsy if cancer was detected. By the early 90's, lumpectomies and *modified* radical masectomies performed after the biopsy were standard proceedures instead.

 

Typically, the only problem with the delays are the nerves. And that, as you're experiencing now, can be horrible. My advice is to keep your fears and impatience from your mother and everyone go out and have fun and laugh! Keep busy.

Edited December 12, 2008 by Kathy in MD

[KAR120C]

As others have said, it might very well be an issue of how likely it's an aggressive cancer (or cancer at all -- they can tell quite a bit before the biopsy, and it sounds like they recognize her problem as a benign one).

 

My dad was even older when he had an MRI that showed "a spot" on his kidney and they were VERY fast to address it. They did a second scan almost immediately and then sent him to surgery all within about 48 hours.

 

The MRI was part of a workup for prostate cancer that they knew he had, but that they knew was non-aggressive, so it was put on the back burner (for months!) while they addressed the kidney and while he recovered from that surgery. It wasn't a matter of not getting the care he needed - it was a matter of addressing urgent matters urgently and non-urgent matters later. (And for survival rates -- kidney cancer survival is abysmal, but it's been almost ten years and my dad is fine. Age is not the main determiner of survival.)

 

I know it's nervewracking, but there are many many things a lump can be other than cancer, and many things they can tell about it before the biopsy. If you can go to the appointment with your mom you might get more straight answers but I certainly wouldn't go in with the assumption that they don't care. It's much more likely that you haven't heard the whole story yet.

[Michelle in AL]

Hi Holly, I'm not a doctor, but I've had breast calcifications that were highly likely to be breast cancer and was followed for 2 yrs. With breast cancer, they can often tell if calcifications are from malignancies by their shape and size. A large lump of calcifications would most likely not be cancerous, maybe that's why they're not too worried by your mother's. Small, scattered crystals that follow a line, as inside a duct could indicate cancer as well as microcalcifications that look stellar (like a constellation).

[kalanamak]

 

There is a big difference in my mom's care and my friend's care. Both are going to Methodist Hospital (the same hospital).

 

 

 

It may be your mom has gone to a doc with a fuller schedule. I'm a doc. I know the docs in my local area, and yet it took me 2 weeks on the cancellation list to be seen for a painful condition, and another 2 weeks to get on the OR schedule. Two weeks later, post-op, I threw a gallstone and spent 30 hours waiting in pain, my fever climbing, for an OR spot. They were that busy.

 

You could try calling around for a doc in the area with less of a waitlist. New to the area docs, or perhaps ones who are perfectly good surgeons but with poorer bedside manners, so that their patients don't tell all their friends about it.

 

I doubt it has to do with your mother's age. Many people don't have elective surgery around the hols, and many docs take vacation then. And nursing and OR staff. HTH.

[Vida Winter]

Holly,

 

I have a lump that is going to be biopsied and removed on either Jan 7th or Jan 21st. I am going with a longer wait time because I want to go to a local hospital instead of driving for hours. We live in a rural area. I just met with my surgeon yesterday for the first time. I've already been mamm'd and ultrasounded and those came back okay. This has been going on since the end of July (I'm 47). I also have to have a colonoscopy at the same time thus the wish for going to a local hospital (I know, TMI, ugh).

 

My point is that even if you have a lump, unless they really suspect that something's going on, waiting a bit is not unusual. My husband is a doc and I'm sure he could have gotten things moving more quickly for me if I had asked him to but this is how I've chosen to approach it.

 

My hopes and prayers are with your mom for a good outcome. :grouphug:

 

Dana

[Mommyof4ks]

Maybe it is because we have been in 'cancer land' for 2 years, but I would be happy that the docs are willing to wait. If your Mom is not on the top of their list it means that they are not worried about it being cancer. We have discovered that if you fade into the crowd, then all is well. If the doc calls you personally then worry. If your Mom wants tests done sooner, then she just needs to push for answers as to why they are waiting. My grandmother has calcium deposits that she has had removed about every 10 years for most of her life (she is in her 70s) and no cancer has ever been found, so hopefully it is just calcium deposits.

 

:grouphug: while you wait. You can always go searching around on BC boards for 'typical' wait times.