Expert: Paula Damgaard - 3/12/2009

Question
Dear Paula,
My mother is 81 and has "mild" Alzheimer's - she knows everybody, can make conversation, but her memory in conversation is very impaired. She may repeat the same question every 5 minutes.  She has been diagnosed with breast cancer and the doctors are recommending a masectomy as she had it 20 years ago and had all the radiation she can take.
We have been told that she could totally lose her memory with general anesthesia. She had an operation a year ago with general anesthesia and it did seem to degrade her somewhat.  Are there any ways to anesthesize her that won't degrade her memory further?

Answer
Bob, unfortunately I am not an anesthesia expert.  I do know that anesthesia and dementia do not mix well.  They don't totally lose their memory, but it does take them down a few pegs.  It is very hard for them to come out of it mentally.  She will have a rough time of it.  

I would get a second opinion from another doctor.  Seeing that she has AD and the future is not rosy for her, could they not do something palliatively?  Give her the best quality of life she could have without the surgery?  

Surgery on an 81 year old in general is not easy.  Even an cognitively intact person would have a hard time recovering.  Are they sure that the cancer is no where else in her body?  

I know there are other options besides aggressive surgery that could be looked at.  There are some "gentle" chemotherapy agents now that might be used.  Please check into every venue before you subject her to the knife.  It won't be easy for her or you.  

Good luck and let me know how you fair.  Paula