Mom is 92 and in NH. She has dementia and is almost blind from side effects of past shingles. She is very happy but easily confused about where she is and where she’s going and needs constant reassuranance. She has had a small pimple-like bump on her face for about 2 years, that comes and goes. The NH usually just treated it with warm compresses and it has gone away in the past, but this time it’s not going away. And I think she’s picking at it as well. We took some close up pictures of it and DH showed them to his skin cancer dermatologist, who thinks it’s basal cell by looking at the pictures, and wants her to come in. Probably a biopsy and then return trip for removal if nessessary. I got her their 1st available appointment for late August. This will give me some time to decide if I want to pursue this. I’m dreading the 40 minute transport with her, the pain she might experience with the biopsy, and then another trip for removal. I’m not sure if we should just ignore it. DH has had many bouts with basal, squamous, and even melanoma, so he thinks it should be treated. But he’s not 92 and vulnerable. Does anyone have any experience with this type of cancer or situation with their elderly confused parent? Thanks.
Also ask what the long term prospects are if she does not receive treatment? If she has already had it for two years is it likely to kill her?
Dad is 89, cognitively with it and has one or more skin cancers removed each year for the past 15 or more years.
Mum at 84 had a skin cancer removed from her face last year. The doctor did not do a biopsy first, just removed it all, tested the edges to make sure they had it all before they stitched her back up.
Our mom had several basal cell growths removed a few years ago, using the MOHS surgery (she would not listen to me and developed a second one before the doctor treating her macular degeneration said she should have it looked at! Sure mom, listen to HIM but not ME!) She was living alone at that time, but was already forgetting things, including that she even had this done. The second one that developed, on her nose, also required a skin graft.
She did develop another on her cheek last year (age 93+). The location bothered me the most - we are trying to preserve her eyesight AND there is so much less tissue (skin and below) on that part of the body for it to burrow into... So off we went. Yes, that long drive IS a pain, but he felt it was basal cell (this time right about where her glasses frame would cover the upper cheek.)
Although they prefer to do MOHS, given her age and that they would not let me be in the room with her, AND that it can take hours depending on how deep they need to go, I thought it best not to go there. He did a biopsy to confirm. Yup. So we went back again for a "deeper" punch biopsy. Results showed more cells still on the edge, but after a final recheck, we are just monitoring this. So far I have not seen any recurrence. Just turned 95 (going on 3!)
If someone were very direly ill, more than likely this would be pointless. However given relatively good health and functionality other than memory, it would be wise to at least have it checked and weigh the options given.
He did an excisional biopsy , meaning that he took all of it. It was a basal cell, and there were still some cells at the margins. We were given the choice of an additional Mohs procedure, doing nothing or a chemotherapy cream that the NH applied. We chose the cream.