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?

She didn't say whether it would be a GA, and by then I was too discombobulated to ask, I'm kicking myself now. It's awful when you feel that what you thought was quite concerning is just dismissed, she really didn't entertain the idea that it might be more than a superficial skin lesion once we'd said it was painful. And my GP surgery won't cooperate, I know they won't. It will be hard enough to get an appointment at all.

Do you think you are at the point where it might be worth registering your Dad to your local GP surgery and getting his records transferred from his current GP practice? Perhaps then they would cooperate and you can get the appointments and treatment needed. I'm sorry if this is not helpful, just trying to think how best to get your bloody GP to engage.

Did she consider that the skin cancer may have itself metastasised even if she thinks the lesion is not metastasis from another source? (And I would trust the papers you’ve read on the pain as much as her tbh).

It’s all very disjointed isn’t it. I would try to get urgent GP appt to discuss possible metastasis in either direction. Will they see him though?

That’s what I’m thinking. He’s not going to be able to go home for a while.

OP, I'm sorry. Just extending sympathy. Things are moving forward, so that is one thing that's sort of good.

'She told us to make a GP appointment and ask to be referred for a chest X-ray, because although it is concerning she doesn't think it is related to the back lesion, so it's not her department to refer him.'

If you approach your GP and say 'the dermatologist has said my Dad needs a referral for a chest X ray', surely they will do that? I wonder if you put it in writing if that will help.

I don't think she was really interested in his general symptoms tbh, her attitude was very much "this is a skin clinic, I'm not an oncologist". Which is problematic when there's a possibility that a metastasis is being missed. Sorry, I just feel so angry and miserable right now. No advice on looking after the actual wound either, she just prodded it and said "doesn't look infected".

I’m sorry the appointment didn’t go the way you wanted, but at least there is action being taken now. I agree with the previous poster, you need to ask your GP for the chest X-ray referral. Is he under an oncologist at all? If not then hopefully this will be more joined up when he is. Sorry you’re going through this, it’s hard when you have to advocate like this for your dad, and I know how draining it can be trying to chase down the medical specialists and keep everyone else informed of what’s happening.

IV seen a dermatologist once and she checked my entire body for other lesions so she absolutely should have done this as a bare minimum today.

YANBU - sorry no one has still taken bloods! It’s unbelievable but then again I am not a professional but in my eyes this should have been done whilst awaiting the derma apt.

i hope you are able to get a chest Xray asap for your poor father xx

Also, how’s your dad coping with the news? Was he able to comprehend it, and do you think he’ll retain it?

He understood it at the time, but he's already forgotten - that's not to say he won't suddenly remember it later though!

It's a good sign that the doctor doesn't seem too worried about the tumour. Hopefully in the report she'll send to the referring GP, it will mention the breathing issues and x-ray recommendation. As others have said, you should see about registering him with a GP closer to you for convenience.

When my Dad was diagnosed with liver cancer, it was like pushing water uphill with a fork trying to work out who needed to do what in terms of referrals BUT I will say that once Oncology were in place it got a lot easier. I would phone your GP surgery and say that you're not happy with the Dermatologist making decisions about a cancer that may be a primary and/or secondary and insist on a referral to Oncology first. You may have to be very forceful about it but don't let up. You can't put him through the trauma of an excision possibly under GA without that information.

It really is like banging your head against a wall at times, I'm so sorry you're having to deal with this.

I know he'll need to be registered down here, but I was hoping to put that confrontation off until after the funeral. It's going to be really, really difficult to convince him to come home with us again after the funeral, he's aware enough to know that he'll lose his house (it's a sheltered housing development but the warden services are really minimal) and he hasn't at all accepted that he can't live on his own any more. It's difficult to know how to approach everything.

I think start with the gp receptionist and say you need an appointment asap to schedule an urgent chest xray as per specialist instructions. See where that gets you. If the gp is an absolute dead end and he's still breathless then I would choose as quiet a time as possible and go to a&e. Explain he's breathless, that you'd thought it was perhaps related to an ongoing cancer diagnosis but the Dr says not and you're concentrated it may be pneumonia or something. Breathlessness definitely needs attention and if the specialist and the gp won't deal with it in any way it is not unreasonable to get urgent attention.

I've just come across this thread OP. Last year I had to advocate for my own dad who was much younger than yours and didn't have Alzheimer's. Please shout from the rooftops and do not take no for an answer, without going into my own story you're going to have to be firm. Find the numbers of people who should be helping, it's exhausting but do not let them fob you off and stand your ground.

Sending you and your family lots of love ❤️

Ok, It sounds as though you and your DH have definitely decided that your Dad cannot live alone and you want him with you and I understand that you were hoping to put off all that entails until after the funeral, anyone would feel the same. But your Dad's health needs, I think, mean you need to get him registered at your local GP asap in order to access the treatments needed. After all you are going to have to do it anyway, so why not get that job done now, it should make your life easier in getting appointments booked and hopefully reduce some of the stress in fighting with the local GP.

You can then tell your Dad that he has to return to your home after the funeral because all the medical appointments have been booked to happen local to you, because he will need you to transport him to and fro and look after him after treatment.

The most urgent thing at the moment is to access medical treatment for your Dad so just deal with that at the moment, the housing can wait until after the funeral. If you try and break things down into what is the most urgent it can sometimes help when everything is so overwhelming.

I am so sorry you are dealing with all this, however, I agree with a pp that if you can get Oncology on board it seems easier to get the help needed.

Oh heck, what a stressful day you have had. Bloody well done on keeping progressing it forwards though - you are doing an awesome job. It does sound like some form of oncology people need to be involved, and it sounds like the GP is the route to that. I'm so sorry you have to do yet more pushing to get things there. Have a massive hug, and keep on keeping on.

I would take it a step at a time. Take charge of the situation, rather than trying to convince him to come home with you - tell him calmly what the arrangements are. When he complains explain that the medical treatment he needs means he needs to stay with you for the time being. And then keep repeating that that. Leave the future open. Don’t make big announcements for the moment. Just get him through diagnosis and treatment for his skin and see what the broader diagnosis is.

Does he understand that he has skin cancer?

I'm so so sorry. I'm afraid you'll have to make a lot of noise with your gp if you want to be taken seriously as it sounds like they're just not bothered.
Another way you could get an X-ray is take him to hospital and explain that he's really breathless and you're worried.

I’m so sorry you didn’t get all the answers you needed today @sprigatito .
Good luck with getting your dear dad seen by the GP.

Just wanted to ask - how are you feeling? 💐

Any possibility of registering with a different GP practice ?

Another way you could get an X-ray is take him to hospital and explain that he's really breathless and you're worried

The trouble with that is that it would mean sitting in A and E for many hours.

About the ND introvert bubble bursting - could you set up a WhatsApp group for everyone "Bobs News" or something so you can just update everyone once on there rather than fielding multiple calls? Or delegate a bit of round Robin responsibility to other people so you only have to update one or two very close relatives?

That would be the quickest way to get an x-ray and circumvent the GP problem.

If you took him to A&E at 8am when it’s quietest. Say:

• He’s not registered with a GP here so no option of GP appt
• He has been seen by dermatology who recommended chest X-ray
• Dermatologist commented on possibility of metastasis
• Breathlessness, weight loss etc

They will do bloods and X-ray there and then, and they may refer him to oncology.

Not necessarily. And it’s not the end of the world if you end up with some answers or at least info on what it’s not.