My husband was going to the Dermatologist 3 or 4 times a year for the last 3 or 4 years. His head was basically OK when he decided he wasn't going to cooperate with the ointments for two weeks a month. I decided if he wasn't going to cooperate, I wasn't going to fight it. He has had both kinds of cancer in the last 20 years. But I was there for the last visit and the doctor froze a couple of spots, and he was very startled.

His dementia is substantially worse now than it was 6 months ago. I cancelled the last appointment a couple of weeks ago.

On the other hand, the dentist visit was fine. I was worried about that one too, but it turned out OK.

divvi yes, my husband has had seven basal cell carcinomas so far. He has been good as gold going to the doctor -- the only problem we've had so far is that he isn't really good about leaving stitches alone afterwards. It helps if I can keep bandages on him (not as easy as it sounds.) And he sometimes thinks someone beat him up, and heaven help the guy if my husband finds him. :-)

Up until this week, I might have given you a different answer. Now, I recommend that you take him. Look at the suggestions others gave for getting an uncooperative LO to the dentist (mild sedatives, whatever) on how to minimize the trauma.

The reason I say this: my husband went in for his 3-month checkup. He had a tiny red spot just below his eye. Didn't look like much of anything to me (I'm purely lousy at detecting the tumors -- I think I've found 3 of the 7 so far). Well, it's not a basal cell carcinoma this time, it's a squamous cell carcinoma. They can grow very rapidly, and are invasive and can cause a lot of damage. The PA knew the second he saw it what it was, although of course he biopsied it to be sure. Put a "rush" on the biopsy -- squamous cells don't wait around.

Since your husband has had a lot of trouble in the past, he is a good candidate for squamous cell, too, and possibly melanoma. If your husband doesn't have anything that looks serious to the doctor -- actinic keratoses or even maybe a small basal cell -- you may decide it's not worth the trouble of treatment. You can always talk it over with the doctor and decide whether to decline treatment.

But if it's something more serious, you need to know it's there, before a lot of damage is done.

divvi recently posted:

Sunshyne, i know you have said your DH has had basal cell removed and suffers skin issues. my DH has had ongoing issues too in the past and always made it to the dermatologist several times/yr to have general checkup and things burned off that were suspicious. its been yrs since he has gone now, i am thinking maybe i should take him in but i know it would be hell to just get him to remove his shirt much less all clothing for a checkup. then if something needs biopsied it would cause DH undue stress (me too) and then if it did come back positive then what? continued visits for biopsies/burning? and he picks everything and infects it-i have no clue what i should do. i went to my dermatologist and she said to bring him in for a checkup if i can get him in but i know they will 'find' lots of stuff and will put him thru misery. i am at a loss on what to do at this stage...anyone out there with this issue, and if so how have you decided to handle this???? divvi


First, my husband is not nearly as far along in this journey as yours, divvi. He (mostly) understands what's going on when we go to the dermatologist (enough so that he isn't terribly happy with me for dragging him there.) He has no problem with being examined. He DOES have a problem with finding a raw sore on his face after another one of the actinic keratoses has been frozen off... marches around announcing that boy, will he ever take care of the guy who did that to him, if he can ever find out who it was.

So, anyway, I figure we may still have quite a few years to go. And that means taking care of issues that could compromise his quality of life during that time.

With your husband, let's see. First off, the vast majority of the carcinomas (and the actinic keratoses) have been on my husband's face. There have been some suspicious things that needed freezing on his hands and forearms. Only one carcinoma, so far, on his back, and I don't remember ever having to freeze anything off there. And of course, the reason the problems have been found on his face and hands is because that's where one is most likely to get too much sun. So it's entirely possible that you could find most, if not all, skin cancers on your husband without your husband having to be undressed.

As far as treatment: If it is just an actinic keratosis, then I see no reason to have it frozen off. These are usually very slow to develop, so I would think you could simply keep an eye on it to see if it changes into something more serious.

If the suspicious spot looks more like a basal cell carcinoma, then the question would be how big, and where. Again, these are usually very slow to develop, and it is very rare for a basal cell to metastasize (travel through the body and start up cancer in another location.) So unless it is already fairly large and in a place where growth could be debilitating, again, I would think you could simply keep an eye on it.

A squamous cell carcinoma is a bit more aggressive -- grows more quickly and I think has a slightly higher chance of metastasizing. But again, I think whether or not to treat it would depend on where it is, and how large.

A melanoma, now, I think that would need treatment asap. I don't think that's a very pleasant way to die. Although I could be wrong about that.

So, overall, I would suggest that you simply have the dermatologist take a look at your husband's face and forearms/hands. Let the doctor know in advance that you are not interested in aggressive treatment (freezing suspicious patches, etc), so you don't have to discuss too much in front of your husband. If the doctor finds anything of concern, then you can talk the details over with the doctor decide whether it's something that you want to have treated. If you don't want to have it treated, then I see no reason to even have it biopsied. (I think a good dermatologist will have a pretty fair idea of what a given suspicious spot is ... certainly ours does. He's only been wrong once, and that time, he erred on the side of caution.)

Great advice/info from Sunshyne. Can you examine him before the appointment? If you see anything suspicious, fax the info to the Dr. prior to going?

My DH has had lots of skin problems, cancer included, but he now only goes twice a year and so far no problems with getting him to go. Our Derm. is wonderful with him and she does examine him from waist up - he usually has something on his back too that she has to deal with. But I check his legs, feet, etc before going - so far so good in those places.

Hope everything is fine.

divvi, the other thing about having a carcinoma start up on the back is that I suspect there isn't a whole lot of damage that might be done there. Ask the doctor, of course, but I'd be much more worried about the face, and also anything on the hands that might be close to a major nerve there -- there's so little tissue there, it wouldn't take much to cause a problem.

Starling, I would agree with you were it not for the squamous cell carcinoma my husband had on his lower eye lid. The doctor had told us he thought my husband was pretty much getting past having any more cancers, so we weren't going in for screening as often ... and then that one popped up. And I believe that it may be better to treat something like that, even for a patient in the more advanced stages -- probably not end stage, though -- since the cancer itself would be distressing as it got larger and interfered with eyesight. And the larger it gets, the harder it is to treat, and squamous cell can grow pretty quickly. Plus, much to my amazement, the doctor was right -- even though they had to move more tissue than expected, the wound healed up very quickly there.

Vickie, I routinely check my husband, and I am absolutely hopeless at identifying what's suspicious and what isn't. The things that worry me turn out to be nothing, and the things that look like nothing turn out to be serious -- the squamous cell, for example. Sigh.

Yes, indeed! The time that really got to me ... he had a basal cell removed from his nostril. They didn't want the nose to look funny after the surgery, so they did a graft. To get the graft to "take", they used this little plastic cap, sewn tightly onto his nose with four sutures. It puts pressure on the graft, which helps it get nutrients and form blood vessels.

The next morning, he wakes up and turns over to give me a morning kiss ... and the plastic cap was gone. He'd torn it off in the middle of the night. Gross! I never did find it. Hauled him to the hospital, but they decided it was too late to do anything but just put a bandage on.

Every time I've taken him back to have the stitches removed, most of them have already BEEN removed. I keep the bandages on long after I can supposedly remove them, I slather on the antibiotic cream to keep the wound soft, but it still itches and he just can't remember not to scratch...

Charlotte you need to go in to the Doctor with him. I always type up a list of DH meds and symptoms, things I want the Doctor to know and give it to the nurse as we go in to see the Dr. Then the Doctor can take it from there.