Fao Sqad

[murraymints]

Dr sorry Mr sqad...had a bad night with dad, don't know if you have been following my tales of woe...as you know dad was diagnosed with bile duct cancer and following aggressive chemotherapy and radiotherapy this matter was dealt with amazingly well, however, in recent times he has been presenting skin cancers which have been excised as and when and by and large have presented no problems. Last week he had to have one inside his ear removed, it was an deep invasion to the point of bone showing. Whilst this is healing, have regular inspections by nurse, he complains of extreme pain , not inside but behind said ear. He is on all manner of painkillers, had a pain management interview with gp on Thursday, but no combination of meds seems to help. He seems to benefit from cold ice pack held to back of ear.....any thoughts ?

[Sqad]

Murray....yes, I have been following your father's case from the start and have very occasionally commented as there seems little that I can add.

The skin lumps are interesting and I presume that they are secondary deposits from the primary biliary cancer.

One has to accept that he is terminal at the moment and the relief of pain is paramount. Bone pain particularly debilitating and all attempts at relief should be explor
I would be thinking about morphine, large doses if necessary to at least make is " end" dignified.

Sorry about the tone of my reply Murray, but that is my opinion.

[murraymints]

Not really what I wanted to hear....but ...I respect your opinion ..the pain he feels only at night which I find odd it is not constant....could it in some way be psychosomatic ?

[murraymints]

And only in this specific area ,only following last week's procedure...

[Sqad]

No Murray metastatic bone pain is never psychosomatic.........ask your GP about a drug called Prolia.

[murraymints]

Thanks sqad..xx you're a gem....a much respected , experienced and .....modest one !! ;-)

[Sqad]

murray, my answer to your OP has been worrying me all day long...........

Skin metastasis from bile duct cancer is very unusual and it would be interesting to know what the histology of these skin lesions show.

The ear problem could be a metastasis in the skin of the ear, eroding bone OR direct metastasis into the bone.

Does it matter?......YES. if it is in the skin eroding the bone, then Prolia will have little to offer for the pain, BUT if it is a direct metastasis into bone, then it may ease his pain.

Discuss it with your Dr, but the rest of my answer remains.......

[237SJ]

Could the skin cancers be caused by a compromised immune system due to chemotherapy and not be secondaries?

[Sqad]

237SJ.......they could be, but that would mean assuming two separate primaries.

Unusual, but not impossible.

We may have to wait for murray to answer that for us.

[murraymints]

Update...biopsy came back clear non cancerous..ear healing nicely...pain receding....doctor thinks the secondary skin problems are a by product of chemotherapy !