Hello All. I’ve been on this site forever, throughout all the trials and tribulations for the past 8 yrs of my mother’s health through Afib and congestive heart failure. I may have mentioned that my mother also has invasive squamous cell carcinoma. My mother is on Hospice care now for a month - but only for end stage CHF. While it is the end stage, she is still doing okay thanks to the comfort care of hospice and their wonderful people. Since my mother is no longer treating with doctors, the squamous cell cancers on her body have been going wild! It’s almost as if she is being eaten alive. Before hospice, we were at the dermatologist office for removals of these cancerous cells every month or so. It became very involved with my mother having to spend the day in surgery while they dig into the cancerous areas to make sure they got all the cancer cells from the area. And then biopsied. Even from her eyelids!
I was so relieved when she was accepted into hospice because it meant a break for me from going to constant doctor appts for her heart and also hoping that they could keep her comfortable with the skin cancers. But because she is not on Hospice for her skin cancer, even though it may be affecting her general health, hospice won’t really do anything about the growing tumors on her body. This is starting to affect my own sense of worry because they need attention. But I’m not sure I can 1) get her out of the house due to stairs and her loss of some mobility and 2) see her spending the day at the surgeon having multiple tumors tended to, having them cut out and then them digging around each area to have the surrounding areas biopsied. Then stitches etc. Then the wound care afterward.
I’m not sure if anyone has had these challenges. I try to take this day by day, but I don’t know what to think about just leaving these growing tumors for whatever time she has left. I can’t really make that call as to how much time, but I think she will be here for a while. She is uncomfortable and I’m even thinking she is developing a “smell” about her from these tumors. I just don’t know what to do. Whether to subject her to all-day surgeries again or to just let things be and accept this is part of her journey now.
I will take this up with hospice on Monday. But just wondering if anyone had to deal with this sort of dual- diagnosis towards the end and what should be done - if anything. While CHF is life-ending in the last stage, I don’t know just how invasive her skin cancer is. She was never tested for metastases. Hope I didn’t make this too confusing. Too much thinking going on.
Usually when on Hospice no extreme measures are taken. Seems like no matter what, these tumors are a constant problem. Maybe they can give her something for the discomfort. The patient is suppose to be kept pain free.
So sorry she has to go thru this.
I completely agree about not subjecting her to further biopsies. The cancer's there, what further useful information can a biopsy offer?
But if one particular growth is causing her clear discomfort, there may be something to be said for removing it, purely as a palliative measure. It can't hurt to ask, and there may be a way of treating it that hasn't been thought of yet.
During my mom's time in the nursing home there was a man there who had a small cancer on his ear, over the weeks I watched it completely take over not just the ear but creep half way down to his chin. Finally the poor man was taken for treatment and most of the ear was removed (the rest eventually healed) - I can't help but think he could have had a simple intervention weeks earlier that would have likely saved the ear, relieved his suffering (he did complain that it hurt!) and cost the healthcare system less too.
I am dealing with the return on my non-Hodgkins Lymphoma now and I will be doing chemo starting the end of June. I told this to hospice, so I’m happy to see they are taking care of this situation. There is no way I can get her out of the house, into a car, and spending a lot of time having this taken care of. My mother really likes her hospice team and I am so happy for this. She doesn’t know I have cancer, but rather thinks I am anemic and going for iron infusions. (I am very anemic due to the blood cancer).
Have a a blessed day everyone!
You are right in that tending to wounds and stitches can be a problem.
I would however discuss with the Nurse about implications if these become larger open wounds what they would suggest. One of the problems towards end of life is skin breakdown and this may make matters worse.
Is it possible to "Freeze" some of the areas without doing biopsies? Or remove areas in the office without going into "surgery" A local anesthetic would be easier than a general if that is what she has had in the past.
The Hospice should have a Wound Nurse that you could also talk to to get their opinion on what you should do for your Mom.