Finger Squamous Cell Carcinoma

  • 10 replies
  • 35 subscribers
  • 2022 views

Hello,

Firstly, thank you for any help offered

yesterday I finally got results back on a finger issue I have had for the last 4 months, which confirmed after a biopsy I have Squamous Cell Carcinoma of my index finger 

some background. 
I suffer from a rare autoimmune condition for which I have taken immunosuppressants for almost 20 years (azathioprine & prednisone)

4 months or so ago I scraped my finger on a wall and I thought nothing more of it. It didn't heal but I assumed due to my immunosuppression it was just delayed. It started to change into what I thought was a wart so I treated it with some OTC remedy. Again it didn't heal. I got antibiotics off my GP and came to Wales to visit my folks for Christmas (I'm based in London usually) after it still not healing I saw my parents GP and got more antiobiotics and was told due to my penicillin allergy if these didn't clear it I'd need IV antibiotics . I ended up trying IV antibiotics in hospital over new year and that's when cancer was first suspected after an MRI scan. Initially it was suspected to be a sarcoma but on inspection of the MRI the Swansea MDT ruled that out but wanted a biopsy done. The orthopaedic surgeon on the day of the biopsy was sure it was a Squamous Cell Carcinoma (SCC) - this was the first mention of the SCC I'd heard, previous orthopaedic surgeons hadn't mentioned this. CT scans and follow up MRIs to determine if the 'sarcoma' had spread had found a blood clot in my IVC and a shadow on my lung but this all turned out to be not related and not any metastasised cancer. 
 

however now I've had the biopsy back. It's apparently confirmed the SCC and I'm only being given amputation of my index finger as an option. Having googled various information on this it appears MOHs surgery is the gold standard of treatment for SCC and I'm wondering why this hadn't been even discussed with me. Obviously the docs know better than I do so it might be the case that the cancer is spreading past the point MOHs would be an option but due to a combination of my previous difficult history, my not being told it was likely to be an SCC until the day of the biopsy (and SCC being the most common type of skin cancer, I'm a little unsure why this wasn't suggested as a possibility until two weeks ago) and the fact I'm away from my usual specialists and London hospitals so I'm bouncing around various Welsh hospitals I'm wondering if amputation is the go to down here whereas it may not be in London etc.

I'm now trying to speak to the orthopaedic consultant i saw yesterday but his secretary hasn't got back to me yet. She was due to send me my biopsy report digitally so I could read it (I got the sense the surgeon wanted me to see it in black and white so I'd realise amputation was the safest, sensible option) but due to the trusts security settings they can't apparently send it digitally so she's now stuck a copy in the post.

Really I'm just reeling a little from the news of amputation more even than the thought of cancer. My autoimmune thing has taken lots from me and while that has been well managed and moving to a better traent regime recently has meant things were greatly looking up this had knocked me for six. So I'm looking at every and all aspects of treatment before I'm willing to contemplate amputation. I'm due to go back and see the orthopaedic consultant next Tuesday for a decision. I've not actually spoken to anyone 'cancer related' as yet.

thanks for any help,

cheers

NB: the surgeons told me some aspects of my finger were (and I forget the correct terms used) 'viable' for excision whereas others wouldn't be. 

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

    I'm afraid I don't have a comparable experience to you as my BCC was on my chest and removed by simple surgery. However, I can fully understand you wanting to explore all avenues before agreeing to having your finger amputated.

    I did a search in the group to see if anyone else has mentioned having a finger amputated but unfortunately drew a blank.

    As you say you need to have all the facts before you before making your decision and I think if I was in your position I'd want to have another word with the person who recommended this course of treatment so that I fully understood why they felt this was the best/only option.

    Do come back and let us know how you get on and, in the meantime, it would be great if you could pop something about your diagnosis and treatment into your profile as it really helps others when replying to you and also when looking for someone on a similar pathway. It also means that you don't have to keep repeating yourself. To do this click on your username and then select 'Profile'. You can amend it at any time and if you're not sure what to write you can take a look at mine by clicking on my username.

    x

    Community Champion Badge

     "Never regret a day in your life, good days give you happiness, bad days give you experience"

  • Hello. Thanks for the welcome and advice. I updated my profile as suggested. Hopefully you’re on the mend now! 

    just can’t believe that something I thought was just infected a few short months ago can now be considered an aggressive type of cancer with amputation seemingly the only option given to me. 

    I appreciate this is clutching at straws but are ‘poorly differentiated’ parts of a histology report ever not malignant. Obviously as a layman I don’t know cancer diagnoses so am only getting information from googling the various terminologies in the seemingly rather short biopsy report I’ve read. I’ve not spoken to any cancer docs as yet just the orthopaedic docs who I first saw about the hand issue. They emailed me a copy of the biopsy they organised and I’m yet to discuss it properly with anyone yet and am not due to until Tuesday so I’m not sure if googling is helping or making me worse. Essentially the biopsy report says some parts of the sample are well differentiated. Some poorly and somewhat spindled and not knowing these things I’m wondering how can I effectively have the complete spread of cells in one sample. I’m an awkward Sid health wise at the best of times having a very rare autoimmune condition so take azathioprine anyway and this apparently makes me very prone to SCC, however imaging reports suggest the bone in my finger is ‘abnormal’ as well now but I don’t know if that abnormality is the result of many years of prednisone for my autoimmune condition, the fact I’ve broken and damaged my finger a few times in the past or directly related to theSCC. The fact this all has come from an innocuous scratch on a wall is really also flummoxing me. Even my vasculitisdoecialist says he’s not seen this presenting like this and suggests it was probably happening below the surface and the scratch just bought it too light. Although me scratching the finger at exact spot the tumour has now grown from seems very unlucky / lucky / bizarre 

    cheers 

  • Hi 

    I'm sorry but as a layman too I don't know what the phrase "poorly differentiated" means either. You could ask about this in the ask a nurse section of the online community and one of the specialist nurses will respond within 3 working days. Whilst they don't have access to your NHS records they can explain terminology, etc.

    I would recommend that you stay way from Google and wait until you get the opportunity to speak to a member of your team on Tuesday. We've all strayed down the Google path but, unfortunately, we usually come away more confused or worried than ever.

    Let me know how you get on on Tuesday.

    x

    Community Champion Badge

     "Never regret a day in your life, good days give you happiness, bad days give you experience"

  • Hi Pingu I had an on line chat with one of the cancer nurses and she was very helpful.  Perhaps try this and ask their advice about the phrases they have used.  Good luck and keep in touch 

  • Thank you both. Did speak to a nurse online following suggestion. Got a bit of advice. Had my consult on Tuesday. Still only went to amputate. Wasn’t given any other option and still only seen orthopaedic consultants. Not a cancer doc yet. Seemed like my finger was too far gone up save but still a little confused by it all especially why I’ve not seen a specific oncologist yet 

  • Hi

    That must be very disappointing that amputation is the only option but hopefully they were able to explain why.

    You don't normally see an oncologist unless you're being given adjuvant treatment and that doesn't usually happen with BCC.

    When I was diagnosed with melanoma I only saw a dermatologist and then the plastic surgeon that did my wide local excision and sentinel lymph node biopsy. This was exactly the same when I had my BCC removed, ie a dermatologist referred me to a plastic surgeon who removed it.

    Do you have a date for the surgery yet?

    x

    Community Champion Badge

     "Never regret a day in your life, good days give you happiness, bad days give you experience"

  • Thank you for the message. I had the procedure done yesterday. Gutted by thought it was at least over. However I received a text while in recovery of an appointment with clinical lead of Swansea MDT sarcoma team for this week. Doc who performed surgery didn’t know what this was about so we dismissed as mistake however now received letter confirming appointment today and now it’s Saturday I can’t speak to anyone. Terrified now. Was initially referred to sarcoma team for bone sarcoma. Then told wasn’t on further exam but they still wanted biopsy done.which was done by doc from yesterdays team carcinoma and treatment planned via this team. Swansea mdt team meets Wednesday so I guess they’ve since seen biopsy and now I’ve appointment of unknown reason with them. This doesn’t seem normal especially when appointment is with clinical lead of MDT

  • These things always seem to happen at a weekend when you don't have the chance to speak to anyone immediately Disappointed 

    I hope you're recovering well from yesterday's procedure and you can try and distract yourself doing something you enjoy until you can get on the phone on Monday to find out more about your appointment.

    Let me know how you get on

    x

    Community Champion Badge

     "Never regret a day in your life, good days give you happiness, bad days give you experience"

  • Thank you. Was doing ok and now this has sent me sideways. Enjoy your weekend!

  • Thinking of you and hope you get some better news on Monday.  Let us know how things are going for you. Take care