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Dorothy - Interview 20

Age at interview: 81
Age at diagnosis: 79
Brief Outline: In 2007 Dorothy's doctor found she had an inoperable pancreatic tumour which he suspected was malignant. She is not having treatment now because the doctor said that it would have limited benefit at the expense of quality of life. Dorothy feels quite well.
Background: Dorothy is a housewife. She has three children. Ethnic background/nationality: White British.

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 In 2007 Dorothy developed constipation, which was quite painful. She also noticed that her stools were pale in colour and that her urine was dark. She went to see her GP who told her that she looked jaundiced. The GP sent her to the hospital, where she saw a consultant, who sent her for an ultrasound scan, and a CT scan. Soon afterwards Dorothy went back to the hospital outpatient department for an endoscopy, which she had with a sedative, so she did not feel anything. During the endoscopy the doctor fitted a stent into Dorothy’s bile duct to relieve her jaundice.

 
Dorothy returned to the hospital to see the consultant. He explained that she had a tumour, which was encasing the portal vein. He said that he had not done a biopsy but he suspected pancreatic cancer. He had not seen any evidence of metastatic spread. The consultant said that surgery was not an option and that since Dorothy felt so well it would be better to leave things as they were. He said that treatment, such as palliative chemotherapy, would have limited benefit, and might have side effects and so might reduce Dorothy’s quality of life. Dorothy agreed with the consultant, partly because she felt well at the time and was not in any pain. She also signed a form to say that if anything desperate happened, such as a heart attack, she did not want resuscitation.
 
The consultant referred Dorothy to the local Douglas Macmillan service, and a nurse from the local hospice called on Dorothy to make sure she was alright and not in need of any help. At the moment Dorothy feels quite well. She is no longer constipated. She sometimes feels a bit breathless, but gets out and about and has managed to get travel insurance to go on holiday. She likes to get on with her life and does not dwell on her condition.
 
Dorothy was interviewed for Healthtalk in 2010
 

Dorothy explained why she did not want to be resuscitated and why she had signed a document...

Dorothy explained why she did not want to be resuscitated and why she had signed a document...

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And they, they said to me, I think it was at that time they said, “Well, if anything does happen do you want to be resuscitated?” And I said, “No.” Because I thought I haven’t got any near relatives, nobody lives near. If I get into a state where I am resuscitated and then I’m sort of living life as an invalid of some sort I don’t want that. I’ve had a good life, and nearly 82 and I thought right, I am now, but then I thought, even then I thought well, no, if I’m nearly going to go, let’s go. It doesn’t worry me, and I’m quite happy with that situation. I’ve got a handicapped son, but he’s in care, and I see him every fortnight, but I know he’s being looked after so I thought right, no, let it be. And the two daughters are quite happy with that suggestion, so that’s it.
 
Did you have to sign a piece of paper to say that?
 
Yes, yes.
 
What did it say on the papers? Did it say, “Do not resuscitate.”
 
No, that’s right, yes, yes, I think it was a red piece of paper if I remember rightly, red form I think yes. But, I thought no, that’s it, if things get really bad I’d rather go at that stage than hang on and have people trying to keep me going. What for? If you’re a real invalid, so that was it.
 
 

Dorothy felt quite well. She decided to try to forget about her illness and to ‘carry on life as...

Dorothy felt quite well. She decided to try to forget about her illness and to ‘carry on life as...

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And from then I really haven’t done anything. I haven’t been back, I’ve had an MRI scan, and I haven’t been back to the hospital. I haven’t, I’ve perhaps been back to the doctor once just to see how things were, but I haven’t been back to anybody, and I have been fine. And I just carry on with life as normal, I say to myself, “What I don’t know doesn’t harm me and I just carry on, and the doctor, when I went to the doctor originally for the original, what’s the word I’m trying to say? When I first saw him, can I put it that way? And he then said to me, “Well,” he said, “there is a lump or a tumour there. And no way can we operate on that. It is too much enclosed with other
 
Blood vessels and things?
 
Thank you. Other blood vessels, yes that’s right, various things round.
 
And he said, “I think the best thing is you’ve still got a good quality of life, let’s just leave it and just see how you go.” He said, “If we start trying to do chemo or radio you’ll get sickness, most likely. You’ll be very tired and,” he said, “at the moment you’re keeping very well, just let it be.” And that’s what I have done. And I have let it be, I’ve carried on with life as normal, I perhaps get a little bit more breathless admittedly, but apart from that I really haven’t got a lot of difference. And I just keep on going and everybody says how well you look. And I just do the things, I, I walk up into the town. I have quite a bit of social life with the church, go to various activities and as yet, I’m just carrying on in the normal way. So really not a lot has happened to me since.
 
 

Dorothy felt well. She decided not to have chemotherapy because her doctor said that it would...

Dorothy felt well. She decided not to have chemotherapy because her doctor said that it would...

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When he suggested that you didn’t have any more treatment, like chemotherapy, was that an easy decision for you to make, or did you think about it for a while or look for information or?
 
No, I didn’t look for any information at all. I haven’t got a computer or anything so I can’t get on the net. I didn’t look for any information because I thought right, if that’s what they say, I’m, in my mind I thought I may have had this for a while, it may go on for a long while still just in the same position, therefore, just, just go along with it. Just go along with it. I didn’t think oh yes I must have, I ought to have some sort of treatment to get this better, no, because I wasn’t and I am still not in any pain from it.
 
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