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Dermatofibrosarcoma Protuberans (DFSP)

RE: Dermatofibrosarcoma Protuberans (DFSP)

Posted by WestCoast on Apr 25, 2014 9:46 pm

Hi Locostella, I hope your recovery is continuing well. It's been quite the winter - I hope spring comes to Fort Nelson soon so you can get out and about more easily.
Blessings,
Anne
Westcoast.... After two cancers I am still....Happy, healthy and choosing JOY!

DFSP - doctors won't do MOHs since already had excision?!

Posted by KMB on Jan 15, 2017 3:01 pm

Hi,

I had a cyst that appeared as flat reddish/purple circle on the
outside of my skin on my abdomen (it was a little smaller than the size of a dime)
with a hard mass under it removed on 12/21/16 by a dermatologist.

I've had this cyst for 20 years and everyone (Dermatologists as well as other MD's) who looked at it said to leave it there as it was not cancer.

On 12/21 I got it removed, purely as an optional surgery, and it came out as a round yellowish looking
object the size of dime, a smaller perfectly round cyst, and some
feathery looking material. The biopsy came out describing the cyst as
Dermatofibrosarcoma Protuberans (DFSP).

The next step, I was told, is to have another wide excision to remove the entire tumor and margins. I pushed for Mohs Micrographic surgery, but because the surgeon (who does MOHs all the time on other types of skin cancers) said that since I was already cut and there is healing, etc going on now I cannot do MOHs since she would not be able to see clearly what is and what is not cancer under the microscope.

Has this happened to anyone else? I am feeling overwhelmed with fear and do not trust fully what the doctors are saying since they seem to know little about this type of cancer...


Any feedback would be appreciated.
 


 

Re: Dermatofibrosarcoma Protuberans (DFSP)

Posted by Addie on Jan 16, 2017 9:09 am

Dear KMB- I am assuming a biopsy was done. You did not mention. Best of luck to you. Make sure you ask a lot of questions and if you do not understand the answer ask again. I find that doctors will only offer a certain amount of information unless asked.

Re: Dermatofibrosarcoma Protuberans (DFSP)

Posted by Kgwins on Feb 11, 2017 9:21 am

I'm in Toronto but couldn't fine a MOHs doc here for my DFSP.  Apparently they prefer to save their skills for squamous and basal cell cancers.  So I've the option of seeing Dr. Arlette/ Dr. GUillmaud and then a plastic surgeon  or Dr. Dawes (dermatologist and plastic surgeon in one) in Calgary.  

I would really ally appreciate any feed back from anyone about how to choose!  Also, because they are both dermatologists, how can we get clear margins if they can't operate into deeper tissue?    Thank you!!!

Re: Dermatofibrosarcoma Protuberans (DFSP)

Posted by dreena on Sep 18, 2017 4:33 pm

I was recently diagnosed with DFSP. I'm freaking out. It feels like everything is taking forever to fall into place. I have an appointment with a plastic surgeon in Edmonton this Friday. I have not had a surgery yet. I am worried. I am scared. I am 26 and have a 1 year old son. I am an impatient person. My doctor had removed a lump on my shoulder thinking it was fatty tissue. To our surprise it wasn't. Now I've had an open hole the size of a dime on my shoulder for 3 weeks. Nobody is calling me. Nobody is e mailing me back. Any info on this process would be appreciated! I need to put my mind at ease. I'm located in Alberta.

Re: Dermatofibrosarcoma Protuberans (DFSP)

Posted by ACH2015 on Sep 18, 2017 5:08 pm

Hi dreena‍ I am tagging Addie‍ as she has recently posted and hopefully can give you some further information.

Cancer Connection also has Information Specialists that may also be able to help you with more information. You can reach them at 1-888-939-3333.

I am not familiar with your specific cancer. You said your doctor removed a lump on your shoulder. Was that a Dermatologist? I would get in touch with your doctor to find out what your treatment plan is going to be. What is prescribed for you as far as treatment and what is going to be done for follow up and monitoring. It sounds like the appointment with the plastic surgeon to repair the hole in your shoulder. Perhaps this is the only surgery recommended for you.

It is very scary to have this in front of you without answers to your questions. One step at a time. Get in touch with your doctor and find out what the plan is for you first. This gives you a starting point.

I hope this helps you. Keep in touch with your questions and status. We are here to help.

ACH2015


 

Re: Dermatofibrosarcoma Protuberans (DFSP)

Posted by ACH2015 on Sep 18, 2017 6:06 pm

dreena‍ I have copied some information for you from the internet on DFSP. I could not link the website.

Hope it helps you.

ACH2015
 

How do dermatologists diagnose dermatofibrosarcoma protuberans (DFSP)?

Your dermatologist will closely examine your skin. If your dermatologist suspects you have DFSP, you will need a skin biopsy. This is the only way to diagnose skin cancer. Your dermatologist can safely perform a skin biopsy during an office visit. 

To perform a skin biopsy, your dermatologist will remove some of the tumor. What your dermatologist removes will be examined under a microscope. This magnified view allows a doctor to look for cancer cells. 

Sometimes, a second skin biopsy is necessary to diagnose DFSP. 

How do dermatologists treat DFSP?

If the diagnosis is DFSP, you will need a thorough physical exam. You may also need some medical tests. These tests provide the information necessary to create a treatment plan for DFSP. 

Your dermatologist may create the treatment plan. Sometimes, doctors from different medical specialties team up to create the treatment plan. The doctors may include a dermatologist, surgical oncologist (cancer specialist), and plastic surgeon. 

Most treatment plans include surgery to remove the cancer. Because DFSP can grow deep, other treatment may be necessary. A treatment plan for DFSP usually includes one of more of the following treatments: 

Excision (surgery): During this surgery, the surgeon removes the tumor(s) and some surrounding tissue that looks healthy. Removing this tissue helps to catch cancer that may have traveled to an area that still looks healthy. 

Mohs surgery: For many DFSP patients, Mohs (pronounced "Moes") surgery may be recommended. This specialized surgery is only used to treat skin cancer. This surgery allows the Mohs surgeon to remove less tissue than is removed during excision (the surgery described above.)

During Mohs surgery, the Mohs surgeon cuts out the tumor plus a very small amount of healthy-looking tissue surrounding the tumor. While the patient waits, the Mohs surgeon uses a microscope to look at what was removed. The surgeon is looking for cancer cells.

If the Mohs surgeon finds cancer cells at the edge of the removed tissue, the surgeon will remove another small amount of tissue and look at it under the microscope. This process continues until the surgeon no longer sees cancer cells along the edge of the removed tissue. Your Mohs surgeon may refer to this edge as the “margin.” When the Mohs surgeon no longer sees cancer cells along the edges, the surgeon may tell you that the “margins look clear.”

Reducing the risk of DFSP returning

When DFSP grows into the lower layer of skin, the cancer often spreads out like the roots of a plant. This root-like growth can make it difficult to remove all of the cancer.

To reduce the risk of DFSP returning after surgery, your dermatologist may include a second treatment. The second treatment helps to kill cancer cells.

Dermatologists also are studying new treatment options. One way to reduce DFSP from returning may be to treat patients with both excision and Mohs surgery. In one small study, the cancer did not return when patients received both excision and Mohs.

More research is needed to find out whether this can reduce the risk of DFSP returning.

Reconstructive surgery: DFSP can grow deep, so some patients need reconstructive surgery to repair the wound caused by the surgery.

Radiation treatments: After surgery, some patients receive radiation treatments. These treatments can destroy cancer cells. Because of the long-term risks involved in getting radiation treatments, doctors carefully consider the benefits and the risks of this treatment. 

The results from a small study show that radiation may reduce the risk of DFSP from returning. Researchers followed 14 patients who received radiation treatments, mostly after surgery. Most patients, 86%, remained cancer-free. The average follow-up period exceeded 10 years. 

When surgery is not possible

Some patients cannot undergo surgery. When this happens, other treatment options are used. Some patients have radiation treatments. Other options include: 

Imatinib mesylate: This is a chemotherapy medicine. The U.S. Food and Drug Administration (FDA) has approved this medicine to treat DFSP in adults when the cancer:

  • Cannot be treated with surgery.
  • Returns after treatment.
  • Has spread to other parts of the body. 

 

Some chemotherapy medicines kill both cancerous and healthy cells. Imatinib mesylate works differently. It is designed to target specific cancer-causing molecules. This gives it the power to kill cancer cells while preventing serious damage to non-cancerous cells. 

This medicine is not right for every patient who has DFSP. For this medicine to work, patients must have certain DNA. Testing is required to find out whether a patient has that DNA. 

If your doctor prescribes imatinib mesylate, you will need to be carefully supervised. 

After taking imatinib mesylate, some patients are able to have surgery because the drug shrinks the DFSP enough so that the cancer can be surgically removed. 

Clinical trial: Some patients are encouraged to join a clinical trial. A clinical trial is a type of research study. This study tests how well new a treatment or a new way of treating a disease works. For some patients, joining a clinical trial may be the best treatment option. 

What is the outcome (prognosis) for patients with DFSP? 

This skin cancer rarely spreads to other parts of the body, so people often live for many years after treatment. 

Lifelong follow-up with your doctors is essential though. DFSP can return after treatment. If DFSP returns, it is often treated with one of the surgeries described above. Some patients receive radiation treatments after surgery. Taking the drug imatinib mesylate may be an option for some patients. 

It is very important to keep all follow-up appointments.

Re: Dermatofibrosarcoma Protuberans (DFSP)

Posted by sgt. pepper on Sep 19, 2017 11:54 am

Wow, what great detailed information.  I have melanoma which is a malignant skin cancer that spreads throughout the body in advanced cases.  I underwent MOHS surgeries for basal cell carcinomas which are not invasive, much like DFSP.  I have never heard of the latter skin cancer but it sounds as if it is not as life-threatening as melanoma.  Nevertheless, it is still cancer and a cause for anxiety.  Hopefully, it will resolve with proper treatment.  My melanoma was successfully treated with immunotherapy most recently. 

Re: Dermatofibrosarcoma Protuberans (DFSP)

Posted by Lianne_adminCCS on Apr 1, 2020 6:21 pm

Welcome to the site kelseydawnb‍ .
I am tagging you here so that you can see this discussion. As you will see, it was started back in 2011 and hasn't been posted on since 2017 but thought I would direct you here in case you can glean some information from it.

I will tag a few of the members that have posted in this thread and identified as having DFSP . KMB‍  Kgwins‍  and dreena‍ 
Most have not been on the site for a long while but in case they get this tag, perhaps they can share their experience with you.

Is this a new diagnosis for you kelseydawnb‍ ? Where you you find yourself in the treatment path now?

Look forward to learning more about you as you are comfortable.

Lianne