Melanoma of scalp diagnosis in my 86 year old mother with dementia. Any insight?
My mother is 86 years old and in around stage 5 dementia, still recognizes people but losing walking ability and thought processes quickly. She was diagnosed with brain atrophy on MRI this past summer, no mention of anything else seen. I was just told by a dermatologist this week that he highly expects a skin biopsy about the size of a dime from her scalp to come back as melanoma. We had pointed it out to various docs who just ignored it. Though understanding the severe treatment of melanoma, and her advanced dementia, she has no desire for melanoma or cancer treatment per se. Just wondering if treatment towards recovery is not chosen, what are the next steps or tests required, if any, and what is a life expectancy for this if not treated? I can only find such information regarding full treatment, excision, grafting and chemo, but not what we're looking at if left alone. Derm said not to tell her as skin cancer was always a huge anxiety for her and he's known her for years. Week prior she was saying she just wanted to die without even knowing this complication, and has already refused invasive treatment for hydrocephalus shunts and doesn't even want to be put on insulin injections. She's just done with life she says. Still waiting to hear back from pathology on what happens next. Does anyone have any familiarity with how melanoma progresses without treatment? Having had a MIL go through the full spectrum and terror of dementia, perhaps this will be easier for her than later progression of dementia to not knowing us or where she is and being a complete panic case with her lifetime anxiety issues. Truly don't know what to think or what's next. Thank you for any insight.
Hospice will make sure that she is never in pain. That is what we all worry about! Their specially trained nurses/aides can see through the dementia to determine if the person is in pain or not. We were told that dementia blocks the ability of a person to actually remember that they hurt - that is why UTIs take off so quickly in them - they don't report symptoms. I don't know when my mthr is hurting, so I really need someone else to figure her out and keep her pain free!
I'm suspicious that your other docs knew this was melanoma, and did not think it should be treated. Every doc knows what to look for... You have to die from something, and dementia/Alzheimers seems like an undignified way to die from my perspective. Complications from cancer, though it sounds scary, sound better to me than being completely dependent on others for care and a long, drawn out death from dementia when you don't even understand what is happening to you.
Dying Well by Byock helped me come to terms with this whole idea of choice in dying. I highly recommend the book for all who will be part of this decision. GB!
We were told by N/H staff when my MIL with dementia stopped walking that her life expectancy would be expected to be no longer than six months from their experience. They were correct.