How to talk with mom about breast cancer treatment

[Quark09]

Hi all -

I'm having some difficulties communicating with my mother regarding her breast cancer treatment. She was diagnosed over a year ago with an estrogen-sensitive breast cancer. After undergoing a lumpectomy and radiation, she went through one round of chemo and had some very nasty reactions (to the Neulasta shot; her liver enzymes were also too elevated to continue chemo). She was prescribed Femara, to be taken over the next 5 years.

She's had some extremely unpleasant side effects from the Femara (excruciating bone pain, fatigue, etc)... enough to make her want to discontinue it. She also started seeing a chiropractor, who encuraged her to stop taking the Femara (calling it poison, as a matter of fact) and started her on a regimen of Poly-MVA, Vitamin D3, and Osteo-B plus.

I've not found a single peer-reviewed study of the Poly-MVA (for which she's paying $150/8oz); a lot of anecdotal "testimonials" found on the web, and not much else.

I'm in Korea right now, but am returning to the States in a couple months to help her out. She quit taking the Femara because her onco basically just told her she needed to deal with the side effects. I want to talk with her about these drugs and her options, but I'm at a loss - she thinks her chiro knows best and is no longer seeing her oncologist.

Have any of you other nurses had more experience with patients or family taking Femara, or any insights into how I can discuss this with her? Thanks in advance for any assistance.

[mama_d, BSN, RN]

Sorry to hear that you and your Mom are in this crappy situation. Can you present her with the facts that you have and convince her to see a different oncologist? Maybe another doc would be a better fit.

I'm in St. Louis and every year we have a list of "top doctors" that gets published...these are not docs chosen by how much paperwork they can fill out correctly or anything like that...they are docs who are chosen by other docs as thes that they'd send their family to. Maybe there's a similar listing for your area and you can get her to go to one of them since they are "the best of the best".

[mentalhealthRN]

I would say this is looking at giving medical advice which we can not give. If you are not pleased with the care a family member is getting it is always good to encourage that person to get another opinion, to change doctors, to make that person realize that they are a consumer and have there are a lot of docs and it is a pts right to find care elsewhere if they are unhappy or think they are not getting what they need. That is all I can say really. Good luck to you and your mom.

[leslie :-D]

i'm not sure op is asking for medical advice...maybe more like anecdotal stories?

that said op, i recently experienced something very similar...

where a loved one dx'd w/ca, opted not to go through with the whole gamut of recommended txs.

this woman researched everything, and decided on her own, what she was willing to do and not do.

if the femara is being used prophylactically (to prevent rising estrogen levels), i can respect your mom's decision.

it's scary, yes.

maybe you could persuade her to get another opinion...

and NOT from a chiropractor...but another oncologist.

wishing your mom the very best.

leslie

[Quark09]

Thanks for the replies... no, I was not asking for medical advice. I'm trying to figure out how to talk with my mother, and want to avoid language that might come across as paternalistic or devaluing her opinions. In the end, it is her choice - I just want her to make an informed one.

Thanks again!

[AlsgalRN]

Is Femara her only option? I am taking Tamoxifen and have no real side effects. I am not yet menopausal. Is she willing to get a second opinion from another oncologist?

I hope she does well with whatever she chooses to do.

Hugs to both of you from an (almost) 4 year survivor,

AlsGalRN

[honey101]

It sounds like she is using integrative medicine and with the results of current cancer treatments I can see why. The research is solid, chemo, radiation and surgery have done their damage and not as much success as one would think. We researched many different options and used a combination of therapies that has helped our family members with various battles of cancer from lugn, breat, colon, prostate and pancreatic. We worked with an integrative oncologist that used polymva in an outcome based study for over 5 years now. the patients and staff we met are worlds apart from any oncologist we had ever gone to and we and many others that we met are alive and dong well, while others that were in the conventional treatments have long passed. century wellness clinic in Reno Nevada with dr. jim forsythe is what we would recommend. good luck and god bless, honey

[Quark09]

Well, she's switching oncologists to someone closer, and hopefully I'll be back in the States in time to go on her first visit with. She'd had a complete hysterectomy 10 years ago and was on a pretty high dose of Premarin, which, of course, she's discontinued. The Femara is prophylactic, and we're going to do a wait-and-see: follow ups with her new onco every three months, blood draws, etc. She's not going to take the Femara for now, and she already feels much better (no severe night sweats, energy is up, etc). She had spots on her lungs and one on her thyroid that haven't grown. In the meantime we'll look for a good PCP (her chiropracter was trying to get her to see him for her primary care needs). Thanks very much for the replies; we're going to work together with some integrative options and hope for the best!