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Skin & Wounds

The skin is the body's first line of defense against bacteria.

There are a number of skin symptoms that come with cancer and cancer treatments. Skin problems may include dryness, rash, itching, peeling, sores, pain and swelling.

It is important for you to be aware of skin problems so they can be treated quickly to reduce discomfort and the risk of infection.

Skin & Wounds - Patient Handout

  • Patients with cancer may have sores (lesions) on different parts of the body. Lesions may be flat or raised, may be a different colour from other skin, may be filled with fluid or pus, and may be open with active oozing or dry.   
  • A chronic sore or wound that does not heal can be a serious burden. It can also be a sign of disease advancement.
  • Malignant wounds may smell bad, may have oozing, bleeding and be painful.
  • Every malignant wound is unique. Some people may have many of the above symptoms and others, only a few.

Each person responds differently. Painful sores can affect people's physical, psychological, social, sexual as well as spiritual well being.


How do skin lesions happen?

  • Skin lesions are most common for people who have had cancer of the breast, head and neck, melanoma, soft tissue sarcoma and some cancers of the genitourinary (genital) system
  • Lesions may be the result of a primary cancer or a metastasis to the skin from a local tumor or from a tumor in a distant site
  • Lesions usually occurs via the lymphatic system, bloodstream, or directly from the primary lesion
  • As a tumour breaks through the skin, it can stay open and the skin can start to die and smell bad

Charcoal dressings and topical antibiotics such as Metronidazole (generic name) may help to decrease odor from malignant wounds.


Skin care during radiation therapy:

Treatment with radiation can cause skin reactions called radiation dermatitis. Chemotherapy or biotherapies may cause skin rashes.


All radiation must pass through your skin. This may cause a skin reaction in the treated area that increases over time and can continue for many weeks after treatment is complete.


About 10-14 days after your treatment starts, you may notice the following changes to your skin in the area receiving radiation:


  • Skin may feel warm and sensitive
  • The color may change
  • Sweating may decrease
  • Hair loss may occur in the treated area

Some factors may interfere with healing:

  • Infection
  • Excessive drainage
  • Poor nutrition
  • Poor oxygenation
  • Other diseases such as diabetes
  • Certain Medications
  • Aging

Research shows that clean, well-hydrated skin can help with healing. 


Moisturizers, antihistamines and steroid medications help to relieve itchy skin (pruitis).


Follow these instructions for skin in an area receiving radiation:

  • Be very gentle with your skin
  • Wash around the area when bathing or showering using lukewarm water and mild soap. Gently pat the area dry with a soft towel
  • Avoid rubbing or scratching the area
  • If the skin is intact (not open), gently apply a non-scented lotion or cream with your hands at least 2-3 times per day
  • Try not to apply any lotion or cream within 30 minutes before your treatment appointment
  • If the skin has broken down, wash the area with salt water solution. Your doctor may also ask you to apply an antibacterial prescription ointment to the treatment area, to reduce the risk of infection
  • Be careful not to remove the skin marks placed by the Radiation Therapists. The marks may fade slightly but will be re-marked during your treatment course
  • Your skin will be more sensitive to the sun. Try to protect your skin from direct sunlight and wind
  • Do not use sunscreen during treatment
  • Avoid extremes of hot or cold (heating pads, icepacks, saunas, etc.)
  • Do not use adhesive tape in the treatment area
  • Avoid swimming in chlorinated or salt water pools or hot tubs
  • Wear loose, comfortable, cotton clothing  
  • It is okay to use deodorants, antiperspirants and electric razors, if desired

When choosing a soap or lotion to use on your skin within the treatment area, read the list of ingredients. They are listed in order of decreasing concentration. Water should be the first ingredient. Oil-based soaps and lotions are not recommended.


Ingredients to keep to a minimum include: parfum, lanolin, PEG's, parabens, petrolatum and astringents.  There is no proof that topical Aloe Vera is effective in preventing or minimizing skin reactions caused by radiation.
 
You may be able to use a soap or lotion that you already have at home. If you are not sure, please bring the product(s) in and ask. Be sure to let us know if you have any allergies. 

You can also ask your local pharmacist or natural health store staff to help you select a suitable product for you.


Remember to:

  • Tell your health care team about any changes in your skin, lesions or sores – did anything change in size, colour, smell, itching, bleeding or oozing?
  • Tell your health care team if you have a wound that is not healing. Removing dead skin or tissue, skin culture and topical or oral medications are the possible wound care steps
  • Change the dressings as planned. Customized dressings, prepared by volunteers from the Order of the Eastern Star, are available through your cancer care team. Ask your Nurse or Radiation Therapist for more information


Revised Aug 2014

SOURCE: Skin & Wounds ( )
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