My mother refused active Lung Cancer treatment - ageism?

Hi JET21f68ed,

Welcome to the Macmillan Online Community platform. I’m Kirstine, one of the information nurses here. I am sorry to read of your mum’s diagnosis and the struggles you are facing relating to accessing consultations for her. I can tell you care a great deal about supporting her at this difficult time.

You are right, that age alone should not be a factor impacting potential treatment options. However, doctors will examine a person’s overall health picture, any frailty, cognitive capacity, and performance scores (relating to physical capacity and ability to manage day to day activities) to guide safety and suitability of possible treatment options. The last thing a doctor would wish to do is cause more harm by intervening, than by leaving things to progress naturally and manage symptoms conservatively, which is also a valid approach to managing cancer for some individuals and can play an important part in optimising quality of life.

It can be a challenge for doctors to estimate how an older adult might cope with harsh treatments especially if the first time they see that person they are acutely unwell with something else (you mentioned your mum was unwell with Covid).  When she first went into hospital it may have been necessary to allow time for her to recover from that and possibly unclear which of her symptoms were related to the virus, and which might be cancer related. I agree with you that seeking a review when she was better was reasonable, and it is also good practice for doctors to be willing to review their previous decisions again if circumstances change.

I’d venture, it’s also a good sign that they asked your mum if she wanted treatment as it is very important to acknowledge that it’s her health and her choice. We often encounter older adults who have, over a great many years, formed clear values and attitudes to how they wish to proceed with their health options should they become unwell in later life, but have never felt able to talk with family or others about that.

I’m glad you know how to reach out to PALS if you feel that you’d both like to escalate concerns about mum’s care. We also have a good webpage with advice: If you are unhappy with your care.

Today, you are asking about accessing a second opinion and this link to our website has some good information on that. In brief, though, its often best to ask the GP to make a referral to a new doctor and then that team will decide if they can accommodate the request.

You may also find this recent article from The Lancet interesting in its commentary on Equitable cancer care at any age.

Please feel free to reach back out to us again should you need a space to talk this over.

Wishing you and your mum the best moving forwards,

Kirstine – Macmillan

Cancer Information Nurse Specialist

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. Ref KDf/ AC