What if the Alzheimer’s patient gets cancer?

As if it weren’t bad enough to endure Alzheimer’s disease, when the patient gets a cancer diagnosis things go from bad to worse for the patient and the caregiver. Here’s what’s really interesting though. Studies show that individuals with Alzheimer’s have a lower risk of cancer and that cancer patients have a lower risk of Alzheimer’s.

In the Framingham Heart Study (FHS) Offspring cohort from 1999-2005, 2,043 participants (54% of them women) without dementia were given neuropsychological tests of memory and executive functioning, in addition to brain MRIs. The cohort consisted mainly of highly-educated, white, healthy middle-aged adults.

There were 252 participants with a previous history of cancer, and 1,7791 without a previous history of cancer. Those with invasive cancers, including the largest sub-types of prostate and breast cancer, actually had better executive function, but not memory function, and larger frontal brain volumes when compared to their peers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659723/

In a previous prospective analysis including 1,274 members of the original FHS cohort, cancer survivors were found to have a 33% decreased risk of developing probable Alzheimer’s disease. https://pubmed.ncbi.nlm.nih.gov/22411920/

So, should you breathe a sigh of relief? It’s unclear because the researchers lacked information on the type of cancer treatments the patients received. They didn’t take into consideration whether the patients were getting chemo or hormonal therapy. They also concluded that they had insufficient evidence because the group of individuals were mainly white, well-educated and healthy middle-aged adults. But it does offer hope that if you have or had cancer, your chances of getting AD is and vice versa is less.

What if you’re caring for someone with Alzheimer’s disease who gets diagnosed with cancer?

There are two important questions to ponder in this situation.

  1. What stage Alzheimer’s is the patient in?
  2. What stage and type is the cancer?

Many factors come into play here: age of the patient, the stage of Alzheimer’s, and the cancer prognosis. It’s a tough one. If the person is in the earlier stages of Alzheimer’s, they might be able to understand the treatment and be willing to go through it. If you are their caregiver, be prepared to go to all doctor appointments with them. Take notes, have the doctor make eye contact with the patient and explain and repeat things in simple language, if necessary. Provide the information in a quiet space without distractions. If your loved one is admitted to the hospital, provide the staff with information about their cognitive needs.

If your loved one has advanced Alzheimer’s you’d have to consider whether putting the patient through cancer treatment is something that the patient would want to do. They will be confused, possibly terrified, and suffer greatly from side effects. Also, a person with late-stage Alzheimer’s doesn’t have a lot of quality of life. Is it worth it?

If the cancer is widespread it could result in pain and discomfort for the patient. Or it might be a slow-growing cancer such as prostate, that can be treated without invasive surgeries or treatments.

It can be difficult to know what is best for the patient. If you are faced with a situation such as this, or another difficult diagnosis, get help from a professional social worker or therapist. Have a family conference, but know there might be conflicts that arise when not everyone is on board.

And remember, you are doing the best that you can do. Take care of yourself and remember to breathe. “This too shall pass.”

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

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