80 year old father: melanoma in situ on foot
Hi everyone,
I am posting on behalf of my 80 year old father. Biopsy on his right foot (on the “arch” of the foot, close to, but not on the sole) indicated melanoma in situ. He had WLE 3 weeks ago, but pathology indicated the margins were not clear. Over the phone the consultant discussed various options:
-Further excision, which the consultant indicated may impact my Dad’s mobility, given his age and the awkward location of the lesion on his foot (although he is very active for his age and in excellent health otherwise)
-Surveillance for any recurrence, with optional use of topical solution (imiquimod I believe?)
He will have a follow up consultation when the wound is fully healed.
A key issue here is my Dad’s anxiety when finding out abnormal cells remained - I have tried reassuring him this is currently non invasive but the anxiety and difficulty sleeping persists (we are managing this through his GP)
Also, if relevant, around the same time as the foot biopsy he also had his forehead (BCC) and back (benign) biopsied.
I am wondering if anyone has any thoughts on next steps bearing in mind my Dad’s age, particularly on the following:
-Would further excision guarantee removal of all abnormal cells?
-How likely would a recurrence be?
-If a second visible lesion does appear, is there any chance this could have progressed to Stage 1 or even beyond?
Many thanks for any advice or opinions, much appreciated.
Hi
. This is such a tough one. We are not medical experts, but I have been through similar situations with both my parents and my mother-in-law, so I can speak from that experience. As much as we want to protect our parents by limiting treatments due to their age/life expectancy or insisting on treatments they might feel are unnecessary due to their age, the ultimate decision (provided they are competent) should be theirs.
His mental health is just as important as his physical health. If he is unhappy about the treatment decision or not fully on board, his mental health might be impacted. So, personally, I would follow his lead, as long as he is well-informed. If he decides to go ahead with the surgery, he might want to consider having it done by a plastic surgeon. A plastic surgeon will do a skin graft if the wound is too big to stitch and might be more skilled at avoiding a build up of scar tissue.
There really is no right answer in this situation. Each path presents risks. I wish I had better and clearer answers for you. Please let us know what you both decide and how it goes. Sending lots of gentle hugs your way. - Lori (Team Member)
