Please help. Just found this on my dad's back.

[sprigatito]

My dad's partner died of cancer a few days ago, he and I were with her when she died, and I've brought him home with me until the funeral (and probably permanently). He's got Alzheimer's and his partner was his carer. He's been looking pained and twisting his shoulder, he said it's just a spot, but I made him show me his back and found this. It looks just like the squamous cell carcinoma he's had removed before, only it's enormous. He's lost weight and is pale and more vague and breathless than usual, but I thought it was just grief

This is really fucking bad, isn't it? He survived stage 4 lymphoma in 2017 and has a heart condition. I have a doctor calling me back from 111, but should I just take him to A&E?

Sending you a hug OP. I have no medical expertise but agree it looks very concerning. I would email a photo to GP and ask for an emergency appointment. Bear in mind that they may send him straight to hospital from the surgery so I would also prepare for that and take a bag, and have air cover in place for any other responsibilities if you need to stay with him a while.

So much good advice, I'm so grateful. And for the sympathy as well. I thought we were coping really well with my stepmum's death, DH's job, MIL having a nervous breakdown and caring for dad...but this has just floored me. I can't even cry because I'll frighten him. I've had to explain to him four times today what's happened to his partner, he writes it all down in his little notebook and then he forgets it again. It's heartbreaking.

I'm so sorry this is happening OP. I have no medical expertise however I do work with people with dementia and I just wanted to say if he cannot retain the info that his partner has died maybe use a therapeutic lie such as saying she's popped to the shop or something (something that she would have done). Obviously you know your dad best and if he's not getting distressed each time you tell him she died then that's fine too x

I'm sorry OP hope you can get him seen at your GP very quickly. Don't start trying to guess what it is or a prognosis. Take one day at a time.

Re him not remembering about his partner's death I echo previous posters in saying don't keep trying to tell him. It's just distressing for both of you and doesn't help him in any way.

My mother's partner died unexpectedly in a car accident and she couldn't retain the information. She kept crying every time she was told and it was quite upsetting. We got told by a dementia support worker that we should redirect and change the subject. A bit like you wold with a child. So if he asks where she is you can say she's popped out for a bit and ask if he wants a cup of tea. Or tell him he's at your place and she's at home, and would he like a cup of tea/to watch TV.

We also found asking her a totally unrelated question or giving her something to do like "help me fold the washing Mum" would deflect her.

As dementia gets worse, there's just no point trying to explain things they can't retain or tell them they are wrong in stuff they say. My mum would tell us all sorts of stories and we'd just nod and smile or even encourage her tell us more, even though we knew it was all garbled up and probably untrue. For example she'd tell us about something that happened 40 years ago as if it was yesterday. Or get her husbands and various partners muddled up (sometimes a bit amusing in a black humour way).

Sorry to hear about much you are going through. Try to find some time to look after yourself.

I do distract, redirect, and just enter his reality and go with the flow most of the time, it's just that at the moment there is a lot of incidental talk about funeral arrangements, the kids are upset etc, and he's at that middling stage where he alternates between being completely on his own planet and being much more lucid and remembering things partially, so it's sometimes more frightening for him if I don't tell him the truth. He's getting worse really quickly because of all the stress (and possibly because of the thing on his back) so what works one day doesn't necessarily apply the next. I do take the point though, and appreciate the advice.

Oh gosh that doesn’t look good. But who knows, maybe it hasn’t spread and perhaps it can be removed. Try not to think ahead too far. I’m sorry you’re having such an awful time of things. 😞❤️

So to reassure- that looks like it has been growing a long long time.

that would be on the positive side as if it’s been there that long, and was aggressive, you’d expect it to have spread to bones, brain, lungs etc and for him to be very, very unwell.

of course if it’s been there that long it will have had chance to mutate so even if originally benign it may now have spread, but I would hope not to the extent you’d think from the sheer size.

gp tomorrow, and cross fingers for you.

Oh and if it is bad news, don’t be afraid to say no to treatment.

if his Alzheimer’s is advanced, and you think that prolonging his life with chemo/radio and other treatment will not give him time with a good quality of life, you can ask that they treat to relieve symptoms and improve his life quality, but not aim to cure.

it is hard but “fighting” is not always in the patients best interest. Cancer treatment is brutal.

do you have health power of attorney? You may need to sort that if not.

I do have power of attorney, thankfully. He's already been through two very brutal regimens of chemo back in 2017 when he had lymphoma, I don't think he should be put through that again at 84. I can't bear to think of losing him, but I wouldn't see him put through aggressive treatment just to buy a bit more time.

I do think this looks really bad for him. As soon as I saw it my heart sank.

OP can you tell him you've had a bereavement to explain the funeral talk etc but not have the deceased be his partner? So he'd understand everyone's upset but not be upset himself.

I’m no medic, but just wanted to tell you my Dad had a 9 inch tumour removed from his head and he was absolutely fine afterwards - so it’s not entirely hopeless xxx

I’d call 111.

They will, during the consult, send you a link to upload photos. Once it’s been triaged by them they will make you an appointment with an out of ours GP or with yours tomorrow.

Whatever that is, it looks infected. Does he have a temperature, loss of appetite etc? If so, that needs to be relayed to 111. I wouldn’t leave it until tomorrow, simply because he is not at home, so there could be a delay getting him seen by your GP without 111 intervening.

I would say, having seen relatives with less severe infected cysts, that he’ll need to have that attended to in a day surgical unit tomorrow. They may need to lance it and possibly remove any infected tissue.

Regardless, call 111 this evening.

Sending lots of love OP ❤️💐

Nothing of any medical use to add, but want to say I think you’re doing so well under incredibly stressful circumstances. Bless you and your dad, hopefully the GP can give some more concrete answers tomorrow.

I called 111 just after I posted this thread, I'm still waiting for a doctor to call me back. Had a text a couple of hours ago thanking me for my patience. If I don't hear anything by morning I'll call my gp and try to get him an emergency appointment. I'm not sure whether him being in the wrong city is going to be a problem.

@sprigatito good you’re in the system - hopefully they will call before midnight (!!) and have him booked in somewhere tomorrow morning.

Don’t panic, but do make sure you get a decent night’s sleep, could be a long old day tomorrow. :( Hope they sort it quickly. 🤞

If you have a way of mailing the photos to your GP surgery, with a note, the GP can forward tomorrow to the closest Dermatology department. Your GP surgery can see your Dad as a Temporary Resident and you can fill in a form to do this.

@sprigatito if you’re uploading a photo to anyone can you include a ruler in your pic? Out of context it could look like a magnified photo of a spot.

Hi OP. I’m really sorry to hear this. As someone in a similar position - my father, 86, has Alzheimer’s and has just been diagnosed with cancer - I see it as a bit of a mercy on him.

I think a relatively swift decline from cancer is far preferable to the slow, interminable slide into delirum, distress and total neurodegeneration of Alzheimer’s.

It’s harder for us, clearly, but for them - probably merciful.

Oh heavens. Poor poor man.
Don't worry about being in a different place. Take him alone, register him as a temporary patient and explain the circumstances. TBH you will probably end up registering him with you anyway if he is staying with you. I can't imagine them turning him way given his frailty and the reason he is with you I the first place.
Agree with the PP about not subjecting him to harsh cancer treatment if that is not in his best interest. What an awful decision to have to make. I hope he can be kept comfortable, whatever he has.

The right hand pics shows the scale - it’s huge.

Weird question, but if you were going to measure it, would you only measure the raised lump in the middle, or the big angry areola around it as well?

@sprigatito, you’ll either be able to register your Dad as a temporary patient with your GP, or use an Urgent Care Centre if there is one near you.

Well you could take both - the size of the actual lump and the size of the red area.

To be honest, I don't think it would make much difference. If a doctor asks the size, they're just looking for an approximation so they know if they're dealing with something tiny, medium, large ... what your dad has is clearly massive either way.