Cancer Treatment Decisions: You Can Help Your Caregiver's Double Bind


Breast cancer and melanoma survivor tries to help her mom with breast cancer treatment choices.

Mom, who is in an assisted living facility, had a lumpectomy two years ago and a mastectomy a month ago. She and her oncologist decided for no chemotherapy based on her age (she is 83) and other health issues, as well as Mom’s own decision. Mom and I next saw the radiation oncologist. The doctor said she should absolutely do radiation for this type of aggressive cancer, considering all of the nodes involved and the strong likelihood of the cancer coming back. AND he said it is Mom’s choice. So far, she is saying no and I must be supportive and respect her choice. My heart is breaking, but her will is intact (just like the doctor said to me when I asked if I should “push” her to have radiation).

The radiation oncologist, unlike the surgeon, said this cancer will come back. If she had radiation, he also said she could lose an additional 10 percent of her lung capacity because there could be lung damage to the lymph nodes behind her collarbone because the that is where the top of her lungs are. Six out of 11 nodes removed during surgery had cancer. Mom already gets winded very easily and she has struggles with her mobility.

Mom and I had breakfast out after talking to the doctor. She asked me what I would do. I said if it were me now, at age 53, of course I would have chemotherapy and radiation—I hope to see grandbabies someday. I also said that if I were her age with her health issues, I didn’t know what I would do.

I understand as caregiver that my role is to support my mom any way I can—any way she wishes me to help her. That said, I felt caught in a double bind. If I strongly encourage her to have treatment and there are severe complications, like losing the ability to walk with her walker or severe burns because her skin is fairer than mine or increased susceptibility to illness, then I will feel like it is my fault. If I strongly encouraged her not to have radiation because of the physical difficulty of doing it five days a week in her condition and because of her other health issues, and then the cancer comes back, I will feel like it is my fault.

There it is in a nutshell. A good psychotherapist once said that when you feel you are caught in a double bind, the best thing you can do is to say it out loud. I told my mom my double bind and this was her response. “No, it is not your fault. It is my decision, just like the doctor said!” In a few words, my mom took me out of my double bind trap. Please note that whether you are the survivor or caregiver, this is important.

My heart still aches for Mom. My love and concern and worry are not reduced one drop, and I do not have to be in a double bind when I talk to her about her treatment decisions. I can help her to ask questions, speak to the right people and make her own informed choice. It doesn’t take away the angst or worry, but as a daughter, it takes me out of the middle. If you are a cancer survivor, please take note of this for your own caregivers. When or if you sense that they feel they are in a double bind, consider the kindness of my mom’s words in helping them out of it.

Every day Mom and I have together is a gift. The older I get, the more I learn to trust in God and my heart is breaking and, thanks to my mom, I am not in a double bind regarding her treatment decisions.

If you have any thoughts or suggestions, I would be grateful to hear them.

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