malign kidney tumor

[Anonymous]

My mother has a malignant kidney tumor (1 in). She is 83 and quite active, however, her cognitive functions haven't kept up with her over average physical fitness but she still manages to live at home with some help. The doctor gave us the choice to have surgery to remove the tumor, which can affect her overall health - so a bit risky - but better for the long run - or wait for 6 months and do a CT do evaluate how fast the tumor has grown and decide if you need a surgery at all. Do you have experience with this, I would appreciate any insight - thank you.

[Anonymous]

Major surgery on an 83-year old is not to be taken lightly. The anesthesia alone can damage cognitive functioning. I would be inclined to wait rather than do the surgery.

[Anonymous]

What does she want. I’d wait.

[Anonymous]

Anonymous wrote:Major surgery on an 83-year old is not to be taken lightly. The anesthesia alone can damage cognitive functioning. I would be inclined to wait rather than do the surgery.

This, with the caveat that if your mom’s cognition allows she should have the say, or if she has an advanced directive you should follow it.

[Anonymous]

Op, I would start by knowing what the hospital stay entails. Overnight, 1 night only? I could see this decision going either way. DH had kidney cancer. One surgery was major (they took out one of the kidneys) and one surgery was a microsurgical event, hardly an event at all.

As I'm typing this out now however, I guess my recommendation would be to not do it. There will be follow-ups, a lot of them, either way. Every 3-6 months. For years. That is what is ordinary and that will be stressful. I think you use this opportunity to signal to the doctors that you/she want to take a palatine only approach and not pursue medical procedures, appointments and hospitalizations.

If her cognitive situation was different or she was younger, I'd be answering differently.

[Anonymous]

Thank you very much for your responses, all so helpful. The surgery would entail 1 week stay in the hospital (she lives in Europe). She can still take the decision but she will rely heavily on me. Contrary to the US, you don't have the quality patient doctor talk about what to do, which I appreciate so much here. The doctor is inclined to give it a wait. So I understand from one poster and this is also my fear, that the surgery might be a start to a lower quality of life as it might be a set back, and a surgery is more stressful to the body at this age to recover. She already has a lot of joint pains, shoulder pain, has vertigo but walks daily 1.5 miles. She cannot take care of her finances, she mixes all up.

Yes on the anesthesia, my fear is this, too. Do people have experience that anesthesia was actually not an issue with people 80 and older?

[Anonymous]

Anonymous wrote:Thank you very much for your responses, all so helpful. The surgery would entail 1 week stay in the hospital (she lives in Europe). She can still take the decision but she will rely heavily on me. Contrary to the US, you don't have the quality patient doctor talk about what to do, which I appreciate so much here. The doctor is inclined to give it a wait. So I understand from one poster and this is also my fear, that the surgery might be a start to a lower quality of life as it might be a set back, and a surgery is more stressful to the body at this age to recover. She already has a lot of joint pains, shoulder pain, has vertigo but walks daily 1.5 miles. She cannot take care of her finances, she mixes all up.

Yes on the anesthesia, my fear is this, too. Do people have experience that anesthesia was actually not an issue with people 80 and older?

I have taken care of most of the elders in my family, as well as neighbors and friends. I have never seen anyone past mid 70s go under general and completely retain their prior cognition. Sometimes it is a small change, others more. That is my anecdatal experience. There is a lot of research out there. If you want to google you can find a lot of studies. Many NIH pages are being scrubbed, so if you want to look at studies, I would pull them up and anything that is a US government site make a pdf or screenshot. You can read later

This is an informational page to think about and minimize risk:
https://www.health.harvard.edu/blog/reducing-your-risk-of-changes-in-thinking-following-surgery-2020052219898

I’m really sorry OP, this is a difficult and painful time I am sure.

[Anonymous]

I’d absolutely wait

[Anonymous]

Anonymous wrote:Major surgery on an 83-year old is not to be taken lightly. The anesthesia alone can damage cognitive functioning. I would be inclined to wait rather than do the surgery.

I feel the same way. Doctors really discount how anesthesia can really mess up an old person’s cognition.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Thank you very much for your responses, all so helpful. The surgery would entail 1 week stay in the hospital (she lives in Europe). She can still take the decision but she will rely heavily on me. Contrary to the US, you don't have the quality patient doctor talk about what to do, which I appreciate so much here. The doctor is inclined to give it a wait. So I understand from one poster and this is also my fear, that the surgery might be a start to a lower quality of life as it might be a set back, and a surgery is more stressful to the body at this age to recover. She already has a lot of joint pains, shoulder pain, has vertigo but walks daily 1.5 miles. She cannot take care of her finances, she mixes all up.

Yes on the anesthesia, my fear is this, too. Do people have experience that anesthesia was actually not an issue with people 80 and older?

I have taken care of most of the elders in my family, as well as neighbors and friends. I have never seen anyone past mid 70s go under general and completely retain their prior cognition. Sometimes it is a small change, others more. That is my anecdatal experience. There is a lot of research out there. If you want to google you can find a lot of studies. Many NIH pages are being scrubbed, so if you want to look at studies, I would pull them up and anything that is a US government site make a pdf or screenshot. You can read later

This is an informational page to think about and minimize risk:
https://www.health.harvard.edu/blog/reducing-your-risk-of-changes-in-thinking-following-surgery-2020052219898

I’m really sorry OP, this is a difficult and painful time I am sure.

This is a great reference, thank you. Unbelievable what is happening with NIH sites...