Prostate Cancer & Malignant Melanoma: Should we get a 2nd opinion?

Posted by dreohm78 @dreohm78, Jan 31, 2022

My father was diagnosed with Prostate Cancer in March of 2021 with surgery to remove his prostate. His PSA in May, after 6 weeks of healing, was .125. One month later in June it was .25 and in July it was .50. So, the surgery did not get all the cancer out. It was then in his lymph nodes. He began hormone therapy with for 2 months prior to 37 rounds of radiation. From just receiving the hormone therapy his PSA went from .50 to .08 prior to the radiation. So on December 2nd he graduated after completing 37 rounds of radiation in 2 months. The hormone therapy will continue for a total of 2 years (every 3 months injection), per recommendation of dr.

We all thought he was out of the woods, but God had other plans for him. He developed what we thought was a cold score on his lower lip during the radiation. On November 23rd he went to the dentist, and she said this was not a cold score, but thought it was some kind of cyst. So, we made an appointment with ENT to look at it. She tried to remove all of it but was unable to. It was sent for biopsy on January 4th, 2022. Well, low and behold it came back as Melanoma! So, we begin again on the journey to get rid of this cancer.
Had a CAT scan January 18th per dr Head and Neck Surgery, Otolaryngology
No lymphatic or tissue abnormalities! No metastatic involvement! Great News!

NOW HERE IS WHERE WE WANT TO MAKE THE ABSOLUTE BEST CALL FOR SURGERY AND RECONSTRUCTION AND IM HAVING A HARD TIME WITH IT.
We saw Dr Jennifer Bruening, Otolaryngologist

She is new to Froedert Hospital, and this would be her FIRST reconstruction of the lip.
She completed her undergraduate degree and medical school at the University of Minnesota- Twin Cities, double majoring in Biology and Physiology at the College of Biological Sciences. She then went to the University of Pittsburgh Medical Center for her Otolaryngology-Head and Neck Surgery residency in the research track, where she spent an additional year in Robert Ferris's lab studying the impact of the immune system on HPV-associated cancers. After residency, Dr. Bruening completed a fellowship in Advanced Head and Neck Surgical Oncology at Oregon Health and Science University in Portland, OR. She then stayed to complete a Head and Neck Facial Plastic and Reconstructive Surgery fellowship, focusing on microvascular reconstruction under Dr. Mark Wax.

Today she said the surgery to remove the cancer is easy, but she has to take wide margins because she doesn’t want to have to come back and repeat it. She has to remove half of his bottom lip.
The tuff part is reconstructing it. That will take about 2 hours. They use his lip, cheek, inside, mouth, outer cheek tissue to reconstruct that lip and last resort would be a graph from leg.
She will also take a few sentinel nodes out and have biopsies done. Hopefully he won’t have to have the Parotid gland involved.
My dad will have a 1-2 month recovery time. He may need to learn how to talk, eat, swallow etc after this procedure. He will have a feeding tube for at least a week.

I know this is a very lengthy post my apologies for that. I just want to make sure you have the whole picture. My main questions are because my father is 71 he is only giving this one go at it and I want to make sure we are making the right choice. Should I be getting a second opinion? Should I be taking him to MAYO? When I look up oral malignant melanoma it says "silent killer"
Is it just me or does this dr have studies in multiple areas and reconstruction is not her primary?
Does the immune therapy have anything to do with this cancer? With the timing its something that's on my mind.
Should we be having a PET scan also?
If anyone has any experience with this, I would really appreciate feedback and FAST!
Thank you for your time!

Interested in more discussions like this? Go to the Cancer Support Group.

Hello @dreohm78 Your father and the family have really had a difficult year. Yes, melanoma is a difficult cancer. There are several discussions on melanoma on Mayo Connect, but i think this one might be the most appropriate,
https://connect.mayoclinic.org/discussion/slow-growing-melanoma-on-the-face/
You said that you might consider asking Mayo for assistance. Here is a link for more information: http://mayocl.in/1mtmR63
I will also try to tag some other Connect members who have made these big decisions.
Are you the medical power of attorney for your dad?

REPLY

Hi @dreohm78, welcome. I've added your post to the Prostate Cancer group (https://connect.mayoclinic.org/group/prostate-cancer/) and the Head & Neck Cancer group (https://connect.mayoclinic.org/group/head-neck-cancer/) as well as the Cancer group.

You are asking all the right questions. At Mayo Clinic, doctors in the Head and Neck Cancer Center (https://www.mayoclinic.org/departments-centers/head-and-neck-cancer-center/home/orc-20457069) work together to provide comprehensive care for people with these types of cancers. Your team may include ear, nose and throat (ENT) specialists, medical oncologists, radiation oncologists, pathologists, radiologists, and oral and maxillofacial surgeons. Other professionals are included as needed.

Given that head and neck cancers often distort speech, swallowing, breathing and facial appearance, the surgical team includes both surgeons specialized in removing cancers and surgeons specialized in restoring complex function and cosmetic reconstruction.

It sounds like getting a second opinion with Mayo Clinic specialists would give you peace of mind. Here's more information on how to submit a referral for a second opinion. You can self-refer or ask his physician to submit a physician referral: http://mayocl.in/1mtmR63

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@becsbuddy

Hello @dreohm78 Your father and the family have really had a difficult year. Yes, melanoma is a difficult cancer. There are several discussions on melanoma on Mayo Connect, but i think this one might be the most appropriate,
https://connect.mayoclinic.org/discussion/slow-growing-melanoma-on-the-face/
You said that you might consider asking Mayo for assistance. Here is a link for more information: http://mayocl.in/1mtmR63
I will also try to tag some other Connect members who have made these big decisions.
Are you the medical power of attorney for your dad?

Jump to this post

I am not. My mother is and she will be adding this group shortly. Does Mayo take Medicare?

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@dreohm78

I am not. My mother is and she will be adding this group shortly. Does Mayo take Medicare?

Jump to this post

Yes, Mayo Clinic accepts Medicare. Members have helpful tips to consider in this discussion:
- Medicare and Mayo Clinic: What does Medicare cover? https://connect.mayoclinic.org/discussion/medicare-and-mayo-clinic/

Welcome @ablockel. Do you have any questions you'd like to ask?

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@colleenyoung

Yes, Mayo Clinic accepts Medicare. Members have helpful tips to consider in this discussion:
- Medicare and Mayo Clinic: What does Medicare cover? https://connect.mayoclinic.org/discussion/medicare-and-mayo-clinic/

Welcome @ablockel. Do you have any questions you'd like to ask?

Jump to this post

Dreohm78 is my sister so she’s got it covered! But thanks!!

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