Mohs surgery in elderly

[Anonymous]

Anonymous wrote:

Anonymous wrote:At mid 80s why even take them off if they are precancerous? How long do you expect them to live?

That’s what we are thinking. His doctor insists he’s seen every 3 months and always finds something leading to hours at the clinic for follow up removal and often weeks of bandages

Money grabber. Get a new doctor.

[Anonymous]

Anonymous wrote:This thread is very timely for me. DH is early 80s and has multiple medical issues. We learned today that a mohs surgery that hasn't healed requires reconstructive surgery, which DH may or may not be able to tolerate. The original target lesions were all basal cell ca, so maybe not even worth treating given his overall condition. It was kind of stupid to do the mohs in the first place.

Yet another instance of how you have to be your own doctor, maybe especially in old age.

I’m sorry. I hope he has a safe recovery

[Anonymous]

Anonymous wrote:Pre-cancerous lesions do not require surgical removal. Get them frozen, or use a chemo cream instead.

I did the chemo cream. Very easy. Looked pretty bad because I was obsessive and did it for 10 days instead of 5, because I could see it was diminishing, but not completely gone. Doctor said I would have to have it surgically removed if the cream didn't work. And it is right on my face, very prominent. It's been a year and it hasn't come back.

[Anonymous]

Another vote for the liquid nitrogen approach. My precancerous spots (which are many) are zapped with the liquid nitrogen every six months. It keeps them at bay and isn't painful. Recovery very minimal. I think it can be cruel to put these elderly people through invasive removals regularly. There is a real risk of things not healing which opens up another can of worms. Unless it's melanoma, I would ask to have it frozen off.

[Anonymous]

The medication I used is called Fluorouracil cream. It is easy to use. I had an aggressive basal cell cancer on my scalp while on an immune suppressing medication. Had a large, deep Mohs surgery for it. A few months later found another spot on another part of scalp that was a squamous cell, but much smaller and not aggressive, but also had to have surgery. The next spot, the derm and the surgeon who specializes in immune compromised patients, both said no more surgery. That it was time to manage with medication. I’m only in early 70s. Clearly someone in 80s could be a candidate for using the medication instead of more surgeries.

[Anonymous]

Anonymous wrote:Parents mid-eighties and is getting pre-cancerous lesions removed quarterly. Healing is slow and takes a lot out of them. If you’ve had a parent in a similar situation did you start to spread them out a bit more?

I thought MOHS was an outpatient procedure, local anesthetic. That doesn’t sound too onerous. Though everything is more onerous when you’re over 80.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Parents mid-eighties and is getting pre-cancerous lesions removed quarterly. Healing is slow and takes a lot out of them. If you’ve had a parent in a similar situation did you start to spread them out a bit more?

I thought MOHS was an outpatient procedure, local anesthetic. That doesn’t sound too onerous. Though everything is more onerous when you’re over 80.

Last time he went in he was there for 7 hours, wiped him out for days and he’s already frail.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Parents mid-eighties and is getting pre-cancerous lesions removed quarterly. Healing is slow and takes a lot out of them. If you’ve had a parent in a similar situation did you start to spread them out a bit more?

I thought MOHS was an outpatient procedure, local anesthetic. That doesn’t sound too onerous. Though everything is more onerous when you’re over 80.

Last time he went in he was there for 7 hours, wiped him out for days and he’s already frail.

They go layer by layer through the skin and keep digging until the layers are cancer-free. This can leave a very big wound, especially for someone who heals slowly. So sad to hear that doctors are overprescribing it.

[Anonymous]

My dad is 92 and still very much wants to live, even though he has been bedridden for over a year. He had a painful bump on his forehead, which just wouldn’t heal. After a biopsy, it was diagnosed as being Sarcoma cancer. The treatment is mohs surgery. My sister and I are all for having it done, and so is he. If he was miserable and wanted to die, maybe the decision would be different.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Parents mid-eighties and is getting pre-cancerous lesions removed quarterly. Healing is slow and takes a lot out of them. If you’ve had a parent in a similar situation did you start to spread them out a bit more?

I thought MOHS was an outpatient procedure, local anesthetic. That doesn’t sound too onerous. Though everything is more onerous when you’re over 80.

I am 53 and not a wimp. I just had mohs on the side of my nose for basal cell. It took 15 stitches to close and had a very painful healing period.

[Anonymous]

My 89YO FIL just had Mohs surgery close to his eye that then required eye lid reconstructive surgery after. It did not seem right to me to put a 89YO through this. DH kept asking if there was a less intrusive option but his sibling who was taking their Dad to the doctor's appointments didn't/wouldn't ask. Doctor's do not know how to moderate - if there is a test/surgery/drug/treatment that "could" help they will recommend it. You need to ask about options and always ask what happens if you do nothing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Parents mid-eighties and is getting pre-cancerous lesions removed quarterly. Healing is slow and takes a lot out of them. If you’ve had a parent in a similar situation did you start to spread them out a bit more?

I thought MOHS was an outpatient procedure, local anesthetic. That doesn’t sound too onerous. Though everything is more onerous when you’re over 80.

I am 53 and not a wimp. I just had mohs on the side of my nose for basal cell. It took 15 stitches to close and had a very painful healing period.

I had a similar experience. MOHS procedure on forehead, my face swelled up after it considerably. I missed several days of work after it.

[Anonymous]

I suggest trying imiquimod. I think Mohs is WAY overused - apparently Mohs rates skyrocketed after Medicare cut reimbursement rates for other types of procedures (simple excision, EC&D, freezing, etc). The docs want to get paid so they recommend Mohs for everything now ("gold standard" blah blah blah). Sad state of affairs but here we are (and patients are scared and don't know any better). Scientists don't know precisely how imiquimod works, but somehow it triggers/revs up your immune system to target and destroy the cancerous cells. It is a drawn-out process (6+ weeks) and the raw/oozing/scabbing skin is unpleasant to say the least . . . but new skin grows back and generally there is no/very minimal scarring. And - dirty secret the Mohs docs won't tell you - if it doesn't work or only reduces the lesion - well then you can have it cut out.

[Anonymous]

Age 60, I had MOHS yesterday. It was very easy. About an hour to remove the BCC, then I sat around for an hour until they looked at it under the microscope, then another hour to close up the wound (which was pretty big). Didn't hurt at all, doesn't hurt now (the next morning).

There were lots of other people in the waiting room and I'd say most of them were also about my age, though one fellow was noticeably older.

I think I'd have to be a lot older and frailer for this procedure to be physically challenging to recover from.

[Anonymous]

Anonymous wrote:Age 60, I had MOHS yesterday. It was very easy. About an hour to remove the BCC, then I sat around for an hour until they looked at it under the microscope, then another hour to close up the wound (which was pretty big). Didn't hurt at all, doesn't hurt now (the next morning).

There were lots of other people in the waiting room and I'd say most of them were also about my age, though one fellow was noticeably older.

I think I'd have to be a lot older and frailer for this procedure to be physically challenging to recover from.

Location matters and 80 is a hell of a lot older than 60, we have not found them to be painless or easy in my relative's case. It requires weeks of painful bandage changes too.