Fungation of cancer through the skin can cause disfigurement, pain, and odor.
The physical appearance of fungating tumor or the odor associated with it may cause considerable psychological distress for patients and their carers.
Fungation occurs most commonly with cancers of the breast and the head and neck.
Patients with fungating tumors are usually acutely aware of how unsightly and smelly their lesions are.
Treatment may include
- Palliative radiotherapy
- Hormonal treatment, for sensitive tumors
to keep the area clean, dry, and free of infection. Dressings must be performed in a sensitive and tactful way.
- Obvious infection is treated with povidone-iodine or a similar antiseptic.
- Bleeding is treated with gauze soaked in adrenaline 1:1000, alginate dressings.
- Dressed with a melanin or other nonadherent dressing
- Topical metronidazole gel
- Systemic metronidazole or clindamycin
- Non-opioid or opioid analgesics as required
- Topical morphine (morphine 1mg / ml in Intrasite gel, q12h)
Woodruff R. Palliative medicine evidence-based symptomatic and supportive care for patients with advanced cancer. 4th ed. Oxford University Press, 2004. p. 356.