81 year old father and melanoma diagnosis

Hi all. New to the group.

My 81 year old dad has a body full of moles and he noticed one was bleeding in february so made an appointment. He only did this because my mum was dying of covid in hospital and didn't want us worrying if it wasn't anything. This was a huge step for my dad. Anyway my mum passed away and we are devastated. Dad got an appointment to see the specialist and they sent him for a biopsy. 

Results came back that it was melanoma and he needed to have it cut out by local anaesthetic. He had that done on 12th may and they dressed it until he got the results back. That appointment was today which my sister went with him. This is where we are confused. They said he has 2 options. 1st is general anaesthetic where they cut it out and check his lymph nodes. 2nd is under local and cut it out making sure there's at least 2cm of healthy tissue. Then they said because of his age and he had a stroke in 2005 there isn't option 1 and he wouldn't be offered any treatment even after having it cut out.So why tell us both options? They then said he needs blood tests and a ct scan with dye in his lymph glands to try to see if it's spread and what stage it's at.

We are obviously very emotional as so soon after losing mum but i am also trying to keep my practical head on so i don't fall to bits. Is it usual that patients over 80 aren't given any treatment like chemo etc or is it because he also had a stroke in 2005?

Am i looking into it too deeply but with them saying that are they virtually saying there's nothing more they can do because it is further on? (Can they tell that before the ct scan/lymph nodes etc?)

I know he's 81 and we dread the phone ringing as it is these days thinking somethings happened (took years to relax after his stroke) and especially more so since february. I also know he could die from unrelated causes to this cancer and he also wouldn't want us to know a time line etc.

Sorry for the long post

  • Hi and a very warm welcome to the online community which I hope you'll find is both an informative and supportive place to be.

    I'm very sorry to read that you recently lost your mum to Covid. That must have been an incredibly hard time for the whole family and now you have the worry of your dad's recent diagnosis.

    The two options that your dad has been given are the normal ones when an excised mole turns out to be melanoma.

    The first option of having what's called a wide local excision (WLE) along with a sentinel lymph node biopsy (SLNB) done under a general anaesthetic is offered if the depth of the mole is 0.8mm or deeper. Depending on the depth of the mole an area of between 1 and 2cms is removed all around the original excision site to make sure that no cells have been left behind and this is the WLE. The SLNB is not a treatment but a staging tool to see if any cancer cells have broken away from the main site and are trapped in the first lymph node in the system, known as the sentinel lymph node.

    The second option of just the WLE is what everyone has and is done under a local anaesthetic if a SLNB isn't being done at the same time as it's the normal follow-up treatment when melanoma is diagnosed. 

    Just to give you some perspective, the SLNB is optional and not everyone chooses to have it as it isn't treatment.

    It sounds like because of your dad's underlying health issues they don't want to give him option one because of the risk of a general anaesthetic so instead they're going to use a CT scan instead of a SLNB. The CT scan will help your dad's team Stage his cancer.

    Depending on the depth of his melanoma he's probably either Stage 1 or 2 at the moment (I'm Stage 2). If the scan shows that it's spread then he'll probably be restaged to Stage3. 

    Hopefully your dad will remain at Stage 1 or 2 as then he won't need any further treatment but will have skin checks every 3 months for 5 years.

    If the cancer has spread then his team might look at offering him either immunotherapy or targeted therapy. As for your dad not being offered chemotherapy that's because chemotherapy doesn't usually work with melanoma not because of his age. 

    I hope this helps a little but do come back if you have any further questions.

    x

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  • Thank you so much for your warm welcome and reply. You have made me feel better as my friend had also said that chemo doesn't usually work on melanoma.

    We will just wait for his next appointment now to cut it out and then hopefully get told what stage it is. Thinking back to his results appointment from the biopsy, they did say to him he would have check ups for the next 5 years to which he replied 'so i'll be around until 86 then!'

    Thank you again and i will keep you updated. Wishing you lots of good health too with yours x