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Should someone with dementia bother with a mammogram?

My mom has early onset dementia, she is 64 and her doctor wants her to get a mammogram. I asked why and he said recommendations are for women under 70 to have them every year. I think this is crazy since even if she has cancer I probably would not want her going through chemotherapy since she wouldn't understand what was happening. This probably an bad thought but honestly dying from breast cancer is probably better that losing your mind, personality and sense of self and then dying early anyway.
Status: Open    Jan 12, 2016 - 04:32 AM

Dementia, Senior Health & Nutrition

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Jan 30, 2016 - 06:59 PM

If your mom is not high risk for breast cancer and has no indication of the disease, such as a lump, it probably won’t hurt to skip the mammogram. It sounds like the only reason the doctor wanted to order it was for a routine screening. Hopefully he did perform a breast exam.

However, if she had any indication of a cancer, I wouldn’t completely ignore it. Chemotherapy is not the only treatment for a cancer. I have taken care of people who have ignored their cancer, until it was too late and it was not a pleasant situation for them.

It is understandable that you do not want your mom to have any unnecessary life saving treatments, if she did develop any signs of cancer (like a lump, drainage or bleeding). However, I would recommend that you consider medical attention, just to find out her options, before you decide against any treatment.

I wish you luck in making the best decision for your mother.


Feb 25, 2016 - 10:25 AM

This is a challenging question for patients, families and physicians alike. If your mother can express her wishes then it makes sense to start with her and her physician together, talking about decisions that might need to be made down the road. Not just about cancer, or testing for cancer, but about what her priorities really are for the rest of her days since she has dementia which is likely incurable but can be managed for some time. My own relative with Alzheimers Disease has had slow cognitive decline for over 10 years now, and in that time several medical problems have come and gone. For some people, curing the diseases that can be cured is most important. For others, living (and dying) without any pain or suffering is paramount, even if that means a shorter life by forgoing treatments that would cause suffering. From what you wrote you are obviously wrestling with these ideas, but I wonder what are her thoughts? Stopping all screening tests when one has 5-10 year life expectancy is pretty rare. Most folks at least want to know about any life threatening diseases…whether they pursue treatment is another issue, and some do not. Sometimes not knowing is hard in itself. In my opinion, this is a perfect opportunity to schedule an appointment with her doctor for the explicit purpose of talking about decision making and end-of-life planning. It’s not something that can be done in a regular quick primary care visit for a sore throat, so try to have the doctor commit beforehand to that conversation and that alone. As the eventual decision maker, it will help you as well as her.

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