Mom has had dementia for 12 years. How would you proceed with a squamous cell carcinoma lesion on arm?

Just have him freeze it off. Why does he need to biopsy it? Just remove by freezing…. Simple, easy, painless. She doesn’t need novacaine. At least it will make You feel better if removed 💜

Roseformom, my Dad had that type of slow growing skin cancer due to years of working outside on his parent's farm when he was younger. It took 60 years for that skin cancer to show up. Dad had each growth removed. It wasn't the skin cancer that took him, it was something totally unrelated.

My Mom had "slow growing" bladder cancer for many years, plus a blood cancer. Her doctors both told me that she wouldn't die from this, it would be from something else. Sure enough, it was complications from a serious fall that took her at 98 years old.

I would question the dermatologist as to the future risk of having that skin cancer. Also ask your Mom's primary doctor for advise. And be calm around your Mom, I know it may not be easy, as she may be sensing your fear.

What would your course of action be?
How would mom do with a wound on her arm? Will she leave it alone or pick at it?
Will this be done with local anesthesia or a general anesthesia? General anesthesia is VERY difficult for persons with dementia and they often do not return cognitively to the "baseline", it can take months if they do.
Would you consider any other treatment if needed? Chemo? radiation? (I know a slim chance but gotta ask the question)
Most skin cancers are slower growing.
If it is causing her no pain or discomfort now I personally would leave it alone.

Sorry to be blunt about this...
Your mom will die. Most likely she will die from the Alzheimer's before she would die from skin cancer.

**side note here about the medication that was prescribed to shrink the growth. Look at the side effects that it has. Depending on what the medication is just leaving the growth alone might be your best option. ALL medications have side effects.**

I would consider a different dermatologist for a second opinion. With or without a second opinion, I would suggest a deep discussion with her PCP who hopefully understands who her complete story.

I am having to decide if treatments for some things are worse than the issues. Several times our PCP who is also a geriatrician has asked me... ok, if we run that test and find out it is positive... do we really want to put my husband through the treatment, surgery, etc. Right now he has a hernia and the cardiologist would not approve general anesthesia unless it becomes emergency. I now have to be prepared, if he does have an emergency that needs general anesthesia, whether it is appropriate or not. My mom had been told she should never have general anesthesia again but later had an aortic aneurysm and had no choice but surgery and fortunately she came through it fine, so I know no one knows the best answer ahead of time.

I'm thinking skin cancer surgery may not be risky overall but with dementia consider the recovery... trying to keep her from pulling bandages off, picking at it before it heals, etc. Each issue needs to be considered from every angle before proceeding, unfortunately with some issues only hindsight can be 20/20. As I said, her PCP may give you the best insight to make your decision.

My dad is 81 and dealing with similar situation but in his head. He went through a similar procedure 8 months ago and now on a different spot in his head. He does not want to go through the same procedure again and I do not know if I should force him to do it again. They are awake through the procedure and it is a very slow process as it goes scrape test wait scrape test wait until the test comes negative. He has Alzheimer’s and incontinence. Do I allow him to make that decision I do not know but decided to keep the appointment and see where it goes. He understands for a minute the consequences and is capable of making the decision this I keep reminding him of the appt and explain over and over again and will allow him to decide and will abide by his decision. As I see it it is and it has to be his decision.

hope this gives you a different perspective on things.
Best wishes

My skin cancer was basal cell. I had it at least 5 yrs before I had it removed. Wasn't as big as a dime. I would first see if the creme helps to shrink it. Watch it, if it gets bigger or changes in some way, then go back. The problem would be not so much the removal but the after care, keeping a bandage on it.

"Slow growing" means that it will take years to spread.

My mom's dermatologist also gave her a cream to apply to a squamous cell facial cancer AFTER it was biopsied and there were only edges left.

My mom had a spot on her chest that would ulcerate, bleed, scab over, then heal over and over again, and I too was at a loss as to what we should do about it. I decided I'd ask mom what she wanted to do on one of her better days and she told me to leave it alone, so that's what we did. She lived with a persistent wound for about a year until she died. But only you and the doctor know your mom well enough to understand whether she has decades, years or months left to her - if you opt for surgery I'd ask about the kind of twilight sedation they use for colonoscopies.

My mother had advancing dementia and cancer regrowth on her chin. I told the dermatologist to ignore it. Why on earth would I want to cause the woman further anxiety or prolong her life......either one is cruel in my opinion. Removing the cancer wasn't about making ME feel less guilty....it was about doing the least invasive and painful procedures to my mother in an effort to spare her grief and anxiety.

A man in my mother's ALF had cancer on his nose which his son insisted on having removed. The man was in his 90s but had no dementia. The surgery was harrowing for him, and required chemo treatments afterward, which the son regrets ever signing him up for. The poor man was sick as a dog and disfigured from the surgery, then wound up dying because he just couldn't rebound from the whole ordeal.

I tell you this because there are many things to consider with cancer surgeries for elders, especially with dementia. If there are bandages afterward, chances are she'll try to rip them off. If there is chemo or radiation required afterward, needless to say, it's a mistake to take that route. And last but not least, taking ANY life saving measures for a dementia patient is questionable in the first place. Hospice is a better alternative if she's far enough along. My mother benefited from the comfort care she got from hospice and was able to spend her last months of life in peace as a result of their care. It was a blessing to keep her out of the hospital and away from surgeons and testing equipment, honestly.

Best of luck to you

None of us can answer your question, knowledgeably. Read about the stages of growth and spread. I would not want to give the cancer a chance to metastasize.

https://moffitt.org/cancers/squamous-cell-carcinoma/diagnosis/stages/

She’s had dementia for 12 years. It is incurable and terminal. The end for dementia patients is horrible sometimes. Even beyond horrible. If it were my mom, I wouldn’t treat it. BTW, my mother did die of dementia, and I wished often that something else would take her and spare her that kind of death, but nothing did.