Dermatofibrosarcoma Protuberans (DFSP) lower back

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Hi folks,

Not sure how many people with the same diagnosis I might connect with here - apparently we're quite rare - but I thought I'd say hi anyway.

A year after first seeing my GP about a growing lump in my back, I'm a now couple of months after my DFSP diagnosis and a first excision, when the consultant didn't know what it was.

After getting my diagnosis from a general surgery consultant and the local hospital, I was quite reassured reading about it online. DFSP has a really high survival rate and low chance of metastasis. But the consultant who first removed the tumour had awful bedside manner. She explained some factors made her question the diagnosis and ended my final appointment with, "I'm so sorry, you're so young."

She referred me to the Royal Marsden and after a 2 month wait I got an appointment with the consultant. Who had an equally poor bedside manner, but was actually reassuringly dismissive of my concerns, in a weird way. He recommended another excision under general anaesthetic with bigger margins but still fairly superficial. He said, "I think you're worrying about it too much"! Frustratingly, he also said the method of initial excision at my local hospital means my wound after surgery is more likely to open up and my chance of recurrence is higher.

I had those couple of months of doubt where it was possibly something worse. But luckily feel relatively reassured now that it will hopefully be just a nuisance going forward.

I appreciate this is just my experience. It won't reflect those of other people in this group of even with DFSP.

Anyone else out there with DFSP?

  • Hi  

    Searching for DFSP on the forum there have been a few people on here over the years but not many as you can see here

    My wife has Leiomyosarcoma so understand the wonders of a rare cancer diagnosis and sometimes finding good information can be more difficult though sarcoma uk has something here.

    I am sorry to hear about your experience with the doctors, sometimes because they deal with cancer every day they can become a little bit detached from the massive impact it has on their patients lives - well until cancer decides to visit someone they love anyway. Often the savior in that process is the specialist nurses.

    It is likely you will be having checkups for some time yet but hopefully that will be all you notice. That is all my wife has now as her cancer has been stable for over 10 years even if for her there is not a cure at the moment.

    <<hugs>>

    Steve

    Community Champion Badge

  • Hi AlexDFSP 

    I was also recently treated at the Marsden for DFSP. Have had one surgery and due to go back end of June for another as my consultant felt the margins were to small. I must admit they have been wonderful with me. 

    Have you had the second surgery yet ?  

  • Hey Steve,

    Thanks for your message and sorry my reply is so late. 

    Thank you for your empathy and insight. Yes I can appreciate it's probably tedious to since cancer clinicians.  Especially a diagnosis that is so benign. 

    I've compete treatment now,  apart from check ups as you said, and found the rest of my care (especially from the nurses) fairly good. 

    I'm very relieved to be on the other side. I'll have a nasty scar on my back but at least I don't get to see it!

  • Hi Suz1991,

    Really nice to hear about your story.  How have you found your whole journey?

    I had my second surgery in March and found the care within hospital really good.  They discharged me on the day and the worst part of my recovery was short-lived. Unfortunately my wound opened up a week after the operation,  like it did the first time round, and I've had a couple of mild infections. So I've had to have the dressing changed a few times a week since mid March, which has been annoying. I think I'm almost healed, hopefully in time for beach swimming this summer Fingers crossed

    After reviewing the removed tissue the surgeon said I was with a "99.9% probability cured" which was reassuring.  I've got a follow up in September to check if it has recurred. 

    How are you feeling about a second surgery?

  • Really pleased that this journey is hopefully over for you and just regular check ups. Did they say how often those will be ? Did they say what the check ups will entail ? Did you have to have a skin graft ? 

    1. In November I went to my GP with what honestly just looked like a red mark just below my neck but it felt hard to touch which I thought was a bit odd. He was lovely and called me back 3 times and in January referred me on to a local dermatologist where they did a biopsy and came back as DFSP. I got referred to the Marsten and had the surgery shortly after but she wants to remove more now as feels the margins are to small. She told me im best to wait 8 weeks to as she wants my scar and skin around it to get more elasticity with the hope they can pull the skin in even further and avoid a skin graft. I'm pleased she being cautious but I'm not looking forward to the recovery again esspeically as where it is my skin feels constantly tight and pulls. 

  • Hi Alex,

    I have just been diagnosed with DFSP, with sarcomateous transformation. 

    I had what Dr's believed was an epidermoid cyst removed in November 25, under local anesthesia.  Heard no more, until a call from Sarcoma service in March 26 to tell me I'd been referred due to suspicious biopsy results.

    Confirmed as FS - DFSP and now had Mri and CT tap scans. Waiting to be discussed at MDT tomorrow and then a plan of surgery / treatment. 

    Very scared and this was a huge unexpected shock. How are you now?

  • Hi  Sorry it's taken this long to respond.

    I'm now just over two years from my final surgery at the Marsden.

    I didn’t need a skin graft. I am just left with a fairly gnarly scar in my back over 5cm long and 2cm wide (I joke it was a shark bite Laughing).

    I'm slightly bitter the surgeon in my local hospital didn't do a better job on the initial excision. This would have left a smaller final scar. But I'm grateful they saw me after long delays and I appreciate the diagnosis coud have been a lot worse. 

    I've had outpatient checkups with a doctor at the Marsden every 6 months since. They are very brief, about 2 minutes! They just feel the scar for any noticeable bumps, ask if I've noticed anything and answer any questions I have.

    At my next checkup they said they might change the frequency to yearly. I don't know how long they recommend coming for checkups - something to ask in my next appointment.

    In the meantime I'm trying to feel the scar for any bumps myself to check for recurrence. I feel optimistic it's gone. 

    How has your second surgery and recovery gone?

  • Hi Emgem Thanks for replying, it's nice to meet others with DFSP.

    Honestly, I am very well now. I have a large scar on my back from the two excisions (due to a mistake by my local hospital doctor on the first surgery). I go to the Marsden every 6 months to check for any more tumour regrowing at the scar. At the moment, it's just a minor cosmetic and admin issue.

    Yes I bet that news is scary and a shock after you thought a minor excision had been handled.

    The uncertainty and the waiting must be really difficult.

    Let us know when you find out your next steps, if you'd like.

  • Hi Alex & Suz,

    Got my scan results today and great news that there's no evidence of any metastasis - huge relief !

    So, I have an appointment with consultant on Tuesday to discuss surgery.

    As I have FS variant, they said there's a greater risk of recurrence, so I'll likely need radiotherapy after surgery, but we'll discuss it more on Tuesday. 

    I'm unclear if it'll be general anesthesia, what type of surgery or if I'll need a skin graft yet, but am forming lots of questions ready for Tuesday. 

    I already have a large scar across my back from initial surgery,  so not sure what the options will be. I'll let the experts guide me, but won't be afraid to advocate for myself. 

    I've made it my business to research and be as informed as I can - think its my way of coping to be honest  - bit of a control freak!

    I have chosen not to tell anyone (except my husband) until we know more after Tuesday.  I feel I need more information myself before I'm ready to share loved ones and work.

    Thank you for sharing with me, its hugely beneficial & reassuring. 

    Will keep you updated following Tuesday.