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With most skin problems, the doctor must decide if healing the wound is a
realistic goal. If it is not, then containing it and keeping the patient
as comfortable and pain-free as possible becomes the goal.
Some common skin problems experienced by people with cancer are listed below.
Chemotherapy extravasation. This is the
term used to describe chemotherapy drugs leaking out of a vein. The drugs
can damage the skin where the intravenous (IV) tube was placed or the
tissue around the area it touches, causing pain or burning. Pain or
burning during chemotherapy may not be normal, and you should tell the
nurse or doctor right away. If an extravasation
occurs during treatment, the infusion should be stopped and the wound
cleaned. The nurses and doctors will care for the wound and instruct you
how to care for it at home.
Radiation-induced treatment skin problems. When radiation
treatment kills cancer cells, it also kills some healthy cells. When it
kills cells on the skin, it can cause the skin to peel. Damage to the
skin from radiation treatment can start after one or two weeks of
treatment and usually resolves a few weeks after treatment is finished.
If skin damage from radiation treatment becomes a problem, the doctor may
change the dose or schedule of treatments.
Necrotic wound. This is a wound with dead skin or tissue around
it. A necrotic wound cannot heal if the dead tissue is still present, so
removing the dead tissue is the first step in treating it. This process
is called debridement and may involve surgery,
enzymes or gel, or other methods.
Pressure ulcers (bed sores). Pressure ulcers are sores that form
where there is constant pressure on one area of the body. They often form
on the heels of the feet or the sacrum (tailbone). Ulcers are less likely
to form on parts of the body where there is a thicker layer of fat.
For patients who are confined to a bed, an air or water mattress overlay
may help prevent ulcers. Low-air-loss beds or air-fluidized beds may also
help. For pressure ulcers that are not expected to heal, providing
comfort and pain control and preventing ulcers from getting worse become
the main goals.
Malignant wounds. These injuries form when cancer breaks the skin
and causes a wound. A malignant wound can be caused by cancer from
another part of the body or from skin cancer. These wounds may have a
foul odor, bleed, and can be very painful.
Malignant wounds carry a high risk of infection. They may also exudate, or secrete, a large
amount of fluid or blood. The odor from a malignant wound can be
overpowering and can be managed by placing a competing odor or odor
absorber in the room, such as cat litter, charcoal, or coffee.
Pruritus. This is the medical
term for itching. Pruritus in people with
cancer is most often caused by leukemia, lymphoma, myeloma,
or other cancers. Kidney or liver failure, thyroid problems, a drug
reaction, dry skin, hives, and other skin infections can also cause
itching.
Pruritus that is caused by an irritant, such as
a drug, can be treated by stopping the use of that drug. Moisturizers,
antihistamines, steroid medications, and cooling or painkilling creams or
gels may also help relieve itching.
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