Skin cancer on outer ear

Hello team,

Thank you for being there for everyone on this forum. 

My Dad had a diagnosis of PV blood cancer about four years ago. It is somewhat under control via chemo tablets and regular monitoring, though he is due to have more blood letting soon, as his recent readings have not been too good. He has had pre-cancerous skin cancer cells all over his head for some years.

Last week, we pushed him to check out a patch on his ear, that looked particularly angry. He was told by the Dr that it's "most likely skin cancer" but that a biopsy would be carried out to determine this. The Dr took a photo and referred the case to MDT and we've now been told that Dad has been booked for a wedge excision procedure next week. This has all been done by letter and it's been confusing and poorly communicated. He has not had a chance to ask questions and is very anxious. We are struggling to get hold of anyone to discuss options.

I wondered whether you could shed any light on whether it's common to jump straight to surgery, just from looking at a photo of suspected skin cancer, i.e. without having a biopsy procedure first? We don't want to risk pushing the surgery back unnecessarily, but it's all been very sudden, so my Dad is keen for the biopsy first. He had open heart surgery two years ago, and is generally rather unwell, so we don't want him to have GA unless it's absolutely necessary. Could you shed any light at all, on the decision to skip the biopsy stage? 

Thank you so much. I appreciate you taking the time to read this message. 

Stephie

  • Hi Stephiejane and thank you for your post.

    It can feel very worrying when things happen quickly, especially when the letters are not clear. I’m sorry your dad is feeling anxious.

    Nowadays with high-quality digital imaging (teledermatology), specialists can often diagnose basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) with a very high degree of confidence. If this is the case, they may decide to remove it straight away instead of doing a small biopsy first.

    Removing it will also give the doctors the sample they need to check under the microscope.

    A wedge excision does both jobs at once. It removes the problem area and gives the doctors the tissue they need to make a firm diagnosis.

    For many people, this can be quicker and means they don’t need two separate procedures.

    Going straight to excision saves your father from two separate, anxious waiting periods and two healing processes.

    Your dad’s health problems, like his heart surgery and blood cancer, are important to think about. Most wedge excisions on the ear are usually done with local anaesthetic (numbing just the ear), not a general anaesthetic. This means he can stay awake and it is safer for many people who are not well enough for a big operation.

    It would still be nice for someone to explain this properly to your dad. You could try calling the number on the clinic letter or by calling the hospital switchboard and asking for the secretary of Dermatology or Plastics (whoever is performing the surgery).

     I hope this information is helpful.

    Please get back to us if you need any more information or support

    It might help to talk things through with one of our nurses on the helpline. You can call for free on 0808 800 4040, Monday to Friday, 9am to 5pm.

    Kind regards

    Tina

  • Hello Tina, 

    Thank you so much for your quick reply and all of the useful information. It has helped enormously, and really put my parent's minds at ease.

    We had another letter earlier, with some different dates on, including a pre-op appointment, which had not been mentioned previously. So this means that Dad has a bit more time to prepare, and will have a chance to ask questions, plus we've now got the name of the surgeon and an email address for his secretary. So we feel a bit happier this evening, and your email really did help. 

    What a fabulous platform this is. Thank you. 

    Stephie