Cancer treatment involves a series of treatments including surgery, chemotherapy, and radiation. These treatments are not without their share of problems, which are different for each person undergoing the treatment. The reactions also vary depending on the severity of cancer, the intensity of the treatment therapy, and the patient’s physiological as well as a psychological response to the treatment. A cause for concern is the wounds that result from the treatments, which may take quite a while to heal. Apart from treatment, cancer itself can also cause wounds such as fungating wounds or skin lesions.
Patients suffering from advanced cancer suffer from the most distressing side effects known as fungating wounds. These wounds have a strong odor and also exude pus or blood. Such wounds can have a negative impact on the patient causing emotional turmoil and distress. It causes physiological as well as psychological stress leading to withdrawal from everyday activities. Fungating wounds are caused due to the extension of a malignant tumor onto the skin surface leading to a necrotic lesion. Regular dressing of the wound is absolutely necessary to prevent infection from setting in.
Cancer Treatments and Wound Healing
Radiotherapy involves high energy ionizing rays focused on inhibiting the multiplication of the cancer cells. Radiotherapy is also used before surgery to shrink the tumor, or after surgery to destroy those cancer cells which may have spread. 60% of all cancer patients are treated with radiotherapy during the course of cancer treatment. Radiotherapy has severe effects such as skin atrophy, microvascular damage, and soft tissue fibrosis. These wounds take a long time to heal and sometimes don’t heal at all. Some other skin reactions include erythema and moist desquamation.
Chemotherapy involves the use of cytotoxic drugs as a treatment for cancer patients. Unlike surgery and radiotherapy, it is a systemic treatment. Although used in a number of ways, chemotherapy leads to significant wounds and skin reactions which include hyperpigmentation, transient erythema, palmar and plantar syndrome, and photosensitivity. Some specific chemotherapy agents cause inflammatory reactions in tissues that have undergone radiation leading to blisters, edema, hyperpigmentation, ulcer formation and vesicle formation. One of the common problems faced by patients undergoing chemotherapy is neutropenia which causes the destruction of neutrophils.
Those patients who are neutropenic are at an increased risk of getting infections resulting in infected wounds as well. There are many chemo drugs that cause venous irritation leading to tissue damage. Tissue damage further results in the development of non- healing necrotic ulcers. Tissue damage may occur in specific areas where leakage of chemotherapy drugs may have occurred, leading to severe pain, nerve damage, and loss of limb function which may require amputation.
Depending upon the severity of cancer, surgery is an option and the radical or conservative route will be chosen. Radical surgery leads to major deformities and loss of function. It has many side effects resulting in complicated wounds. Some of the wound-related problems include sepsis, hemorrhage and hematoma, thrombophlebitis, and pulmonary complications. In order to avoid wound complications, continuous evaluation of the wounds is important.