Hard Decisions

Most of you know that my mother in law, Mary Hansen, has stage 4 brain cancer. The prognosis is not good, but the family hopes that radiation treatment will give her a few more good months. To catch everyone up, six short months ago Mary began to show symptoms that once investigated found that she had thyroid cancer. Thyroid cancer is a slow growing, highly treatable form of cancer, however Mary must have had this cancer for years. Her thyroid gland was removed, but the cancer had metastasized and was found in her bones, lungs and brain.

The brain tumors are the most problematic. Over the past few months, she has lost the use of her right arm, and showed significant weakness in her right leg. Radioactive iodine, the best treatment for thyroid cancer, was administered at the Mayo Clinic but has not shown success in Mary's case. A couple weeks ago the decision was made to perform whole brain radiation in an effort to stop the growth of her brain tumors.

That treatment began on 1/19 with the knowledge that tiredness was a likely side effect. After 9 days of treatment, Mary has not shown signs of progress, and has in fact degraded to a point where she can no longer stand or walk without assistance. Getting her out of bed or a chair occasionally requires 3-4 adults. My father in law, Neil, is no longer able to care for her without assistance.

Oldest daughter Cindy was in town this past weekend, so the 3 siblings were able to discuss next steps with their father. It was decided to work with her physician to get her admitted to the hospital, the first step in getting her moved to a nursing home. In watching the decision process, I realized their decision was more difficult than my family's decision to withhold treatment from my father during his last days.

Elements of the decision are nearly identical, except for the patients wishes. My family understood my father's desire to stop treatment. This was a comfort when we decided to remove the ventilator. Mary still has a clear mind, and does not want to spend her remaining time in a nursing home. So the decision was a very difficult one for her family. Nobody wants to put her in a nursing home, but to care for her at home would require full time nursing by a professional or a family member. One extra person would not be enough at times.

The decision was the correct one, but correctness does not make it any easier. Your prayers for Mary and her family are coveted.