Mom had a spot on her forehead that has bothered her over the past year. Her fingers constantly fly up to rub it. It is barely visible, and it didn't seem to be hurting anything, so I was mildly irritated by her obsession with this bump. It seemed silly and vain to me, to be honest, kind of like her urgency to keep a stock of depilatory to remove her (barely visible) upper-lip hairs.
Still, I took her to her regular doctor - twice. He used a substance to try to freeze it off - twice. Each time it came back. The third time he referred us to a dermatologist. I admit I still felt it was just not that big of a deal, though I saw that it had grown quite a bit, so I arranged my schedule to get her to another doctor visit.
After a biopsy, it came back as Squamous Cell Carcinoma In Situ. In the photo below, the one with the circle was the target of the biopsy. The other larger one remains.
The question now became ... what's next? What treatment will we choose? She is 91, on hospice for congestive heart failure, but she could survive for a few more years. What to do?
The dermatologist prescribed a course of Aldara, a cream chemotherapy. After reading about it, I became convinced she would not tolerate the pain, itching, bleeding, and other awful side effects. In talking to the doctor, we learned that the options are:
- treat aggressively with Aldara and suffer the side effects (though the doctor said they are 'not that bad')
- treat less aggressively with Aldara and suffer fewer side effects, possibly slowing any growth
- treat it surgically (to slow it down), but that would likely require a skin graft
- not treat it, knowing that any resultant possible spread of this 'very slow growing' and 'surface' cancer would take more years than she likely has remaining in her life.
She chose Door #4, not treating it, and I fully support that choice.
This was a very sobering consideration, reminding us of the quality of life vs quantity of life. We talked again about her choice being on hospice, choosing not to use life-extending measures.
So, returning to our friend Mr Shakespeare, we read on: