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Posted 8/6/2010 1:12 PM (GMT 0)
This has been a very difficult day.

My husband is due for RP surgery on the 20th and today he dropped in to his GP to get the results of a wart removal on his hand he had nearly 2 months ago. With all the prostate cancer stuff we hadn't thought about it very much but wanted to get it out of the way before surgery. (It's unbelievable the GP never called to tell him the result, this is just a repeat of our experience with the urologist. I will never trust a doctor again)

Unfortunately it was cancer, and as I was not there during what I thought was a routine appointment I don't know how bad it was and whether the margins were positive or not. All my husband  heard was that it was deep and also that the GP said to watch the site to see if anything changes. The doctor definately did not say if the margins were clear on not, only that he cut out as close to the bone as possible so it was as deep as possible. And its Friday evening here and he hasn't got the pathology report.

The fact that my husband has a skin cancer is not surprising, we do live in Australia where 50% of the population gets skin cancer at some point. And my husband is of Irish descent with pale skin and blue eyes. But, given it looked like a wart, its probably a squamous cell carcinoma and that is the bad version and we are not going to get the path report till next week just is going to make this a bad weekend.

I sobbed when I heard, it feels like we are coping with too much at once. In less than three months my husband has been diagnosed with two different types of cancer. I really hope they are not linked. CANCER SUCKS!

An

Posted 8/6/2010 1:33 PM (GMT 0)
So sorry to hear that An. It certainly is not fair, and it doesn't sound like the doctors have been very effective in providing information to you folks. I can only suggest that you keep the faith and dont let this tear you guys up. I remember 1st learning of my pc, and how it seemed like all was lost. Then we find out there are options, and it doesn't have to be the end of the story. I hope that is the case for you and your husband. I'm sure you both have a lot of fight left before you're willing to give up. I know I will say a prayer for you both.
Posted 8/6/2010 1:51 PM (GMT 0)
Oh An, I was so sorry to hear about this latest news. Don't fret too much...squamous cell is not the worst skin cancer - melanoma is. And don't jump the gun about it being squamous...basal cell (which I've had) can also look like a wart and is more common. In my case, I have a 2 inch scar on my right shoulder from a large patch that was removed about 7 years ago.

As to why the GP never called with the results is inexplicable...may I ask why your husband wasn't referred to a dermatologist as they can usually tell just by looking at something what it is? I see my derm every year for a full body check and have been a couple of times in between visits to have him to "look at" something that concerned me. Fortunately, no recurrences of skin cancer but lots of age spots that have had to be removed for biopsy.

As to whether or not your husband's PCa and skin cancer are related, put that thought out of your mind. One has nothing to do with the other.

I know you are worried about the prostatectomy and I won't tell you not to worry because I've been where you're going and know all too well what it feels like to stand by and watch this happen. I hope that you will find the strength and courage you need to get yourself and your husband through this.
Posted 8/6/2010 1:54 PM (GMT 0)
An38....I was in the exact same position. I was given the news about the prostate cancer while being biopsied for skin cancer. Ended up having the prostate surgery followed by surgery for the skin cancer. They were able to save my finger, however it doesn't look very pretty. Squamous cell isn't something you want to mess with.
Posted 8/6/2010 2:04 PM (GMT 0)
An,

I feel for you and your situation. We have not communicated directly and you may not have seen many of my posts in the past. But I can understand where you are coming from.

My wife and I both are dealing with cancer. She for 5 years and me for 1+. It is tough, it does overwhelm and it can make you feel very helpless.

But it is a new world for you. Sadly, one that you have very little experience with on a personal level this close. It takes a great leap of faith to believe that you guys are not the first, nor will you be the last.

Take solace to a degree from all of the brothers and sisters here at HW and know that we have all been where you are at some point in our lives. Yet we are still here. We have our ups and downs and we rejoice in our successes and gain support from our collective strength when we have set-backs.

You have found a place to share and we are linked now for the rest of our lives.

Call on us anytime. We are here for each other. We know from experience that tomorrow will bring joy and comfort in some form or another and to some degree, be it small to tremendous.

As difficult as it may be today, have faith, have trust, and enjoy the love you and your husband share, to the fullest each and every day. I know that is what makes it bearable for my wife and I and many of the couples here.

Sonny
Posted 8/6/2010 2:17 PM (GMT 0)
Les, thank you. If you can get through this, so can we.

Sephie, I know I should wait for the path report but its three whole days before I have a chance of getting it. My husband has a full body check every year, all have been good so far, with the last being in January but this cancer was not picked up. In late March there was a kind of scratch between his first two knuckles which bled. Then it crusted over and my husband was obsessively picking at it so it didn't heal. Mysister who is a doctor was visiting from the US in late May, looked at it and said that it looked like a wart but she didn't like the look of it and it should be excised out. So it was - this all happed really quickly - and unfortunately at the GP and not at a specialist.

Once I get that path report the next step will be to get to a dermatologist. If the margins are not clear he will need some surgery I think. And if so we have to figure out what takes higher priority the PC surgery or the skin cancer.

Bob we are far from giving up but for today, for half an hour it was more than I could handle.

An
Posted 8/6/2010 2:46 PM (GMT 0)
An,

So very sorry and heartbroken for the both of you. It is a terrible blow to deal with both at the same time. I will make no excuses for doctors and medical staff that communicate poorly. Don't let that turn your off of doctors in general. There probably isn't any connection between the skin and prostate cancers, so its not apples to apples. You will just have to deal with this one step at a time, and not let it overwhelm you. Your emotional outbreak would be clearly understood and felt by any person here, male or female. We share your fears, your anquish, and your pain.

Please stay in steady touch, the entire HW gang, myself included, is behind you and your dear husband.

We love our brother/sister Oz folks that are among us.

David in S.C.
Posted 8/6/2010 3:18 PM (GMT 0)
An,

Sorry to hear about your husband. There is a drug in phase II trials and is available for "compassionate use" here in the states. According to the news reports it is effective in about 40% of the cases. I mentioned it to my dermatologist yesterday and he was aware of the drug. But he did say that it only lasts for about 20 months. This was not said in the news reports. I think the drug(s) are the following. There was a peculiar side effect in that the drug turned the patient's hair white but the good news was that if this happened it was indicative of success with the drug.

Bristol-Myers Squibb's ipilimumab and Pfizer's tremelimumab

Best to you and hubbie.
Don
Posted 8/6/2010 3:28 PM (GMT 0)
An38 The aproach of wait and see on the return of the skin cancer was the same protocol my dermatologist used. Unfortunately we stayed on that same protocol for several years, taking a little off each time it came back. I finally went to a center of excellance and was immediately scheduled for MOH's surgery. This is where they cut and sample, cut and sample until you have clean margins. Then follow up with plastic surgery. In the scheme of things, this procedure is actually much easier to deal with than the PCa surgery was.

Best of luck to you.
Posted 8/6/2010 3:47 PM (GMT 0)
An. Thanks for letting us know. I know at times times like this things tend to look very dark but know that we are all here with you trying to shine some light for you.

Please do keep us posted.

Cajun jeff
Posted 8/6/2010 3:51 PM (GMT 0)

Hi An:

Sorry for your angst and the performance of the doctors doesn't help!  In any case, I'll share some thoughts on your issues.  First of all, and coincidentally, I just had a basal cell skin cancer removed yesterday.  It was found during a routine dermatology visit two weeks ago...body inspection, found something peculiar, cut it off for biopsy and called two days later telling me basal cell skin cancer.  The protocol here then is to come in for out patient surgery where they cut a little deeper to make sure they get the margins.  It was no big deal, took about 1/2 hour...now I have 10 stitches and am moving on with life. 

There is a high probability that there is NO connection between your husband's PCA and his skin cancer.  I have the fair Northern European skin also and (probably like your husband) got way too much sun as a kid.  That is a sure recipe for skin cancer but, fortunately, it is usually no big deal.  Hopefully his pathology will come back as basal cell but as long as it's not melanoma or some strange variety you shouldn't be too worried.

As far as the question as to which to take care of first, I think it depends on what your dermatogist says about the pathology.  If it's basal cell then he probably has had it for some time and a few more months probably won't matter, i.e. take care of the PCa first.  However, if you get a feel that the skin cancer is somewhat aggressive then I suggest you get that handled first.  As we have discussed before, you husband's PCA stats suggest slow growing (if not indolent) cancer so a short delay in treating the PCa is not likely to hurt.  I guess the thing I don't suggest is taking care of both cancers at the same time.  From what I know about what CAN happen post surgery for PCa I think you want to be focused totally on that recovery for a few months.

In any case, I'll pray that the skin cancer is a mild sort and I wish you the best.

Tudpock (Jim)

Posted 8/6/2010 4:04 PM (GMT 0)
In NY the waiting time for a dermatologist to perform MOHs is at least 3 months. They are booking late October appointments now.
I am not sure what kind of wait you have in your part of the world, but it might be a good idea to schedule something now. That way if hubby needs some work done 3 months from now, you will already be on the schedule. If everything looks OK you can always cancel the appointment a week before.
Jeff
Posted 8/6/2010 6:43 PM (GMT 0)
Hi An,

Nothing to add to all the excellent posts above-just wanted to let you know that I am thinking about you and your husband.

Renee
Posted 8/6/2010 8:03 PM (GMT 0)
An,
Sorry about the bad news of having to deal with 2 types of cancer. I know all about the sun exposure in Australia being really bad. I hope his skin cancer pathology report will show negative margins. I wish you both the best.
Posted 8/6/2010 8:42 PM (GMT 0)
An,
Sorry to hear that news as well. Hard not to fret when you just have the word "cancer" and no other info. I'd be finding a new set of Doctors. Please keep us posted and lets hope for the best.
Michael
Posted 8/6/2010 9:01 PM (GMT 0)
An,

Sorry to hear your husband is dealing with both.

I had a skin cancer, too. I had a chunk of squamous cell carcinoma taken out of my leg about 10 years ago. about the size of the end of one of my fingers. Pathology said it was contained. I remember asking my GP if that cancer would increase my chances of another one. He said no, yet here I am. I can't say they were related.

Good luck and best wishes.

Mike
Posted 8/6/2010 9:21 PM (GMT 0)
Melanoma is a big deal, yours does not sound like melanoma..The other types of skin cancer are very curable with proper treatment.. Good Luck and Fair Winds..

Post Edited (Fairwind) : 8/6/2010 3:27:56 PM (GMT-6)

Posted 8/6/2010 11:51 PM (GMT 0)
I am so very sorry, An. I will keep you in my thoughts.

In the course of all the tests, we found my husband had a lung aneurysm and some other lung issues. The doctor thinks they are granulomas.

One day at a time.

Mimi
Posted 8/7/2010 12:17 AM (GMT 0)
An these are hard words to hear when your already dealing with one C word already . but cancer puts a hold on everything else, especial when it's someone we love. my husband was dx 2006 PC since then it seems like the whole world  has been turned up side down.and there's nothing we can do about it except be there for them and love them and listen to them.so I wish bothof you the best and I will keep ya'll in our prayers .Today we celebrated our 44 wedding anniversary.
Posted 8/7/2010 2:47 AM (GMT 0)
Thank you everyone for so much concern and empathy. And for making me realise that so many of us are dealing with more than one medical issue at a time.

Yesterday was terible but today is another day. We managed to get our hands on that pathology report today and speak to another GP about it.
Yes it is squamous cell carcinoma (not melanoma thank goodness). But sqamous cell is much more serious than basel.
The good news is that the margins are clear but the bad news is that the margin is only 0.3mm at the deepest point. The GP says that that's the minimum margin recommended for squamous cell.

My husband pointed out two small leisons that have been around for a while (!) and one looks like another squamous cell whereas the other looks like a basel. They have to come out - we have an appointment for Monday. Only problem now is my husband who wants to fit in two games of golf before the PC surgery and since the suspected squamous cell is on his hand he thinks the stitches may ruin his swing or stop him playing. I do not understand his thought process at the moment, he really needs to sort out his priorities but I am leaving him alone to think about it.

Thanks again everyone.

An
Posted 8/7/2010 3:58 AM (GMT 0)
Hi An,
That's a good report considering. Ugh!

Now that my testosterone levels are getting back to normal, I kinda understand your husbands thinking about the golf. When I was on HT I thought I had permanently lost my desire to forego asking for directions or talking with the guys at the water cooler. Shoe shopping was far more appealing than golf. But now, I'm back to being unreasonable and have renewed my subscription to water cooler talk...:-)

All my very best to you and your husband while you step from stone to stone. The good news is that both of these cancers are beatable. Patience and the wonderful wife he has will help a great deal.

Peace to you both...

Tony
Posted 8/7/2010 8:24 AM (GMT 0)

An38 said...
Thank you everyone for so much concern and empathy. And for making me realise that so many of us are dealing with more than one medical issue at a time.

Yesterday was terible but today is another day. We managed to get our hands on that pathology report today and speak to another GP about it.
Yes it is squamous cell carcinoma (not melanoma thank goodness). But sqamous cell is much more serious than basel.
The good news is that the margins are clear but the bad news is that the margin is only 0.3mm at the deepest point. The GP says that that's the minimum margin recommended for squamous cell.

My husband pointed out two small leisons that have been around for a while (!) and one looks like another squamous cell whereas the other looks like a basel. They have to come out - we have an appointment for Monday. Only problem now is my husband who wants to fit in two games of golf before the PC surgery and since the suspected squamous cell is on his hand he thinks the stitches may ruin his swing or stop him playing. I do not understand his thought process at the moment, he really needs to sort out his priorities but I am leaving him alone to think about it.

Thanks again everyone.

An

 

An, I am so sorry you are dealing with this unexpected news!  I am so happy you did obtain the pathology report giving you a few extra days to take necessary steps in dealing with this matter.  I know how stressful this can be.  I feel the dermatologist may provide additional insight.  May God provide the wisdom to take the necessary steps towards complete recovery.  Is there a MRI or ultrasound that needs to be done?

 

I know at times it is difficult to understand the thought processes of our men!  The thing with golf is similiar to Ron and his fishing.  I knew he needed to get away, even for a short time.  Men often use sports to unwind.  Perhaps advice from the doctor may help your husband with this decision?  I think you are handling the matter properly!  I am praying for you both!

 

Sonny, your message was so warm and loving.  It brought tears to my eyes.  Thank you!

 

Aimzee

Posted 8/7/2010 11:00 AM (GMT 0)
An, glad you have the path report in hand and that your husband's skin cancer is not melanoma. As you already stated, squamous cell is more serious than basal cell but is still highly treatable and curable. I can't imagine how stressful this all is for you but please be assured that you and hubby are in the hearts and minds of many of us here at HW.

When I hear stories like yours, a quote from Mother Teresa comes to mind: Lord, I know you never give me more than I can handle but sometimes I wish you didn't have so much confidence in me.

Men think differently than women - you know the old Men Are From Mars, Women Are From Venus. I imagine that the only thing you can do is give him the space he needs to sort this all out - as frustrating as it may be for you.
Posted 8/7/2010 2:32 PM (GMT 0)
An, I have followed this thread with concern for you and your husband and I jump in now for two reasons. One is to wish you both all possible success. While he is dealing with two cancers it seems from the pathology reports that you can have some reasonable hope of a cure for each --- and, isn't cure the "C" word we cancer patients love to hear!

The second reason is your husband's golf. I don't think it's a Mars and Venus thing. I think it is a human response to major stress to revert, often in ways that seem to others unreasonable, to some icon of normality and hold to it fiercely. We have a very close friend (we have celebrated New Year's together for more than 50 years, I'm "Uncle" to her kids and she's "Aunt" to mine) who is in the midst of her second round of chemo after her ovarian cancer returned 12 months after surgery. She knows, we all know, her life is in peril and the chemo is not so much about cure as stalling. One of the things that sustains her is keeping her life as normal as possible. Doing exactly what she's always done, and sometimes, such as when it comes to planting out the spring flowers at her cottage, it is only accomplished because of a bloody minded determination that to those of us wanting to help, or say, "let the gardner do it this year, for Heavens sake!" unreasonable. But, for her, it is a way of being in control and fighting the cancer by doing what she'd be doing if she didn't have cancer.

An, I suggest that your husband's single minded need to play golf has little, or nothing, to do with playing golf and everything to do with making a statement to himself, and to the cancer, that he's in control of his life and will NOT let the cancer dictate to him!

I'll be watching with interest for more news and be assured you'll both be in my prayers on the 20th.

Sheldon AKA Sleepless
Posted 8/8/2010 1:23 AM (GMT 0)
Thank you Sleepless, Aimzee and Tony for your recent comments.

Unfortunately I have done some research on husbands situation and the research isn't good. The minimum recommended margin of healthy tissue for Squamous cell carcinoma (SCC) is 4mm.(Again the second GP is wrong!!) My husband has 0.3mm. This is why the hand is a terrible place to get SCC as it has little removable flesh and is prone to recurrence and metasteses. See text below copied from an article on the internet. My husband's SCC was in the interdigital cleft (the area in between the knuckles).

"Haws et al2 reported a 0.1% to 3% rate of metastasis for squamous cell carcinoma of sun-exposed skin. However, squamous cell carcinoma of the hand is associated with a higher risk of metastasis compared to squamous cell carcinoma of the skin in other regions of the body, having been reported to metastasize in 5.5% to 28% of cases.

In 1981, Rayner described the “danger zone” of the hand to include the dorsal skin of the proximal phalanges, interdigital clefts, and the first webspace. He noted that tumors in this region of the hand were associated with an increased incidence of local recurrence and metastasis when compared to other regions of the hand. The 5-year survival rate for metastatic squamous cell carcinoma is 20% to 40%."

So the question really is whether this situation overrides the RP situation in terms of needing to get fixed and in that case perhaps we will need to move the surgery dates.

I feel helpless and overwhelmed. Any ideas on what we should do next are appreciated.

An
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