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Living with your Cancer Related Wound

A Guide for You and Your Caregiver



Welcome to the CarePartners Wound Care Team! In the pages of this booklet we will tell you about how we can help you to help your wound. This booklet is full of information to help you to understand what is going on with your body when you have a wound and what your body needs to heal the wound or, if it can’t heal, to feel better.


Sometimes we have to use medical terms, so words in italics and underlined will be defined in the glossary at the end of the booklet. Some information will have web links. This means that there is more information either on the internet or on the CarePartners website. You can either click on the link or go to and click on the Health Information tab.



What is a Cancer Related Wound?

A Cancer Related Wound is an open or closed cancerous lesion of the skin. It could be a primary cancer such as Melanoma or it could be the spread of cancer from another site. Some cancers that sometimes spread to the skin include breast cancer, rectal cancer, bowel cancer and lymphoma. If you don’t have cancer elsewhere in your body, you may have developed this cancerous wound from a chronic wound that has been present and unhealed for many years. Sometimes the wound will appear as a growth. This is referred to as a tumor. Sometimes these are called malignant tumors. It may look like a bump, or irregular growth on the skin surface, or it could be an open lesion that looks like a crater. Sometimes they can be quite large.


Cancer Related Wounds can be difficult to deal with because cancer cells have invaded the skin including lymph and blood vessels. This causes tissue to die leading to the possibility of increased risk of infection and bleeding. Sometimes these wounds can drain quite a lot and have a foul odor. Pain and itchiness are often associated with these wounds.


Cancer Related Wounds can be very distressing. Although these wounds usually cannot be healed, the bothersome side effects can be managed.


How is a Cancer Related Wound Managed?

Our nurses will work with you to help you live your life to the fullest by controlling the symptoms from the wound, especially pain. They will know how to use dressings to control odor and drainage and manage bleeding if it occurs.


Management may include helping you to improve your nutrition, increasing your mobility and activity, removing sources of pressure or friction, and suggestions for good hygiene and environmental measures to reduce odor.


If your wound is a large growth (tumor) and the bulk of it is painful or interfering with your daily activities, talk to your nurse or doctor to determine what medical management options might help you to be more comfortable: Shrinking the wound through surgery, chemotherapy, radiation or hormone therapy may be options for you. 


What is Wound Care?

Wound care includes all the activities of managing your wound including what you and your nurse will do to help your wound heal. The nurse will assess you and your wound to determine if your body is ready to heal and will apply dressings to support your wound. Your nurse may need to take pictures of your wound. They will ask you to consent to this.


Wound care also includes teaching you and your significant other to be as independent as possible with caring for your wound.


The management of a Cancer Related Wound depends on the type of cancer, where the wound or tumor is located, how much tissue is involved and the symptoms that you are experiencing. Although a Cancer Related Wound cannot be cured, it can be managed to reduce unpleasant side effects.


At each visit your nurse will assess your wound to see how well the symptoms are being managed. Be sure to talk to her about how you are feeling and what symptoms you are having.  


Your nurse may need to contact your doctor or other health professionals to discuss your wound or to get you a special referral if needed.



Could I have trouble with my skin?

If you have received radiation for your cancer, your skin can become either dry or can be irritated and weepy. The Cancer Centre may have given you a tip sheet on how to manage your skin. Be sure to follow their instructions. If you did not get a tip sheet here are some skin care suggestions:

  • Use a soft cloth,
  • Use clean water and mild soap, such as Dove, for bathing the area,
  • Use circular motion to intact skin around the wound, do not rub,
  • Showering is ok if it doesn’t increase pain or bleeding,
  • Use non-perfumed moisturizers on the skin like Glaxal Base, Cavilon Cream, and plain Vaseline, and
  • Pat your skin dry, do not rub.
  • If the wound is near your armpit and is being treated with radiation, do not use underarm deodorant as this can interfere with the treatment or increase your risk for skin irritation.

Will my Wound be Painful?

Your Cancer Related Wound could be quite painful or could cause the tissues around it to be painful. Pain can interfere with your daily activities, reduce your appetite and make it hard to sleep. It can even slow the healing process. Most pain can be treated effectively with medication or other therapy.


If you have pain from your wound talk to your nurse so that they can suggest medications or other therapy to reduce your pain. They may need to contact your doctor for a prescription.


Your nurse will want to know the answer to the following questions:

  • When does the wound hurt?
  • Rate your pain 1 2 3 4 5 6 7 8 9 10
  • What makes your wound feel worse?
  • What makes it feel better?
  • The medication I will take for my wound is:
  • I take it every _______ hours.
  • Side effects I need to be aware of are:


Consider keeping a pain diary so that you can be accurate when you describe your pain to your nurse or doctor. Here is a sample.



  • When did it begin?
  • How long does it last?
  • How often does it occur?

Provoking/ Palliating

  • What brings it on?
  • What makes it better?
  • What makes it worse?


  • What does it feel like?
  • Can you describe it?

Region/ Radiation

  • Where is it?
  • Does it spread anywhere?

Severity: On a scale of 0 to 10 with 0 being none and 10 being worst possible.

  • What is the intensity of this symptom at present?
  • At best?
  • At worst?
  • On average?
  • How bothered are you by this symptom?
  • Are there any other symptoms that accompany this symptom?


  • What medications and treatments are you currently using?
  • How effective are these?
  • Do you have any side effects from the medications and treatments?
  • What medications and treatments have you used in the past?

Understanding/ Impact on You

  • What do you believe is causing this symptom?
  • How is the symptom affecting you and/or your family?
  • Values
  • What is your goal for this symptom?
  • What is your comfort goal or acceptable level for this symptom (on a scale of 0 to 10)?
  • Are there any other views or feelings about this symptom that are important to you or your family?



If your doctor prescribes medication for your pain, please take it as prescribed. Sometimes people stop taking their medications because they feel better, but the reason they were feeling better is they were taking their pain medication! Follow the instructions; don’t take the medication more often than prescribed. If you aren’t on routine pain medications, have medicine that you can take when you need it. If you are having dressing changes, take your medicine about an hour before you are going to have your dressing changed so that it has a chance to get working. 



Things I can do to Help Manage my Wound 

Complete this with your nurse. Check off as many of the things you think you can try to do to help keep yourself healthy and help manage your wound.


I will try these…

Drainage: Your wound may produce a large amount of drainage. Infection can also cause more drainage from the wound.

❍ Your nurse will assess your wound for infection and if it is infected will ask your doctor for antibiotics. If antibiotics are ordered be sure to take them all.

❍ If your wound is draining, your nurse will choose an outer dressing that can absorb large amounts of drainage while holding the drainage away from your skin. They will teach you and your significant other how to change this dressing in between visits.

❍ Your nurse will show you how to put a protectant on the skin around the wound to protect it from caustic drainage.

❍ If drainage is excessive, a consultation to a specialty nurse can be made to see if a pouch, to contain the drainage, is possible.

Itching: Cancer Related Wounds and the skin around them can become very itchy. This can be from your skin stretching as the tumor grows or from drainage sitting on your skin. Antihistamines may not work, but removing or altering the source of the itchiness can help.

❍ Gently cleanse drainage off the skin around the wound, you can shower if there is no other reason not to.

❍ Review the dressing choices with your nurse.

❍ Change the dressing more frequently if it becomes moist. Apply refrigerated menthol or anti-itch creams around the wound. Talk to your pharmacist or you doctor about topical products to relieve itching.

❍ Different kinds of dressings can keep the skin around the wound cool. An example is a hydrogel sheet dressing.

❍ A TENS machine (transcutaneous electrical nerve stimulation) may help reduce the itching. Talk to your doctor about this because electrical stimulation can sometimes increase cancer cell growth.

Odour: Odour from the wound can increase and become smelly from dead tissue, bacteria and/or stale drainage.

❍ Gently cleanse your wound often. You can shower.

❍ Your nurse can select a dressing that has antimicrobial properties, or charcoal in it to reduce odour.

❍ Your nurse will assess your wound to determine if odour could be reduced by removing the non-viable tissue through debridement.

❍ Change your dressing often so that smelly drainage does not build up.

❍ Mask the odour. Put mentholated ointment like “Vicks” or essential oils at the base of your nostrils to help mask the odor at dressing changes. You can also use cat litter, odour eaters or charcoal in the environment to help absorb odor.

❍ Remove the source of the odour. Bag soiled dressings as soon as the dressing is changed and place in outdoor garbage.

❍ Talk to your doctor about topical or oral antibiotics to control odor from bacteria. A topical antibiotic called Flagyl can be helpful.

Bleeding: Tumor growth can injure small blood vessels causing bleeding. The bleeding can be an oozing continuously or there could be sudden bleeding. This can be frightening when you don’t expect it. Try to remain calm and contact your nurse or doctor if your wound starts to bleed. If the bleeding is sudden and seems like a lot, roll up a clean towel and press it against the bleeding area. Keep the pressure on continuously, don’t lift the towel at all. If the blood is leaking, don’t lift it up but reinforce it with another towel. Go to your local Hospital Emergency Department

❍ For oozing, gently cleanse the wound. You can shower. Try reducing the force of the spray, or do not spray the right on the wound.

❍ If bleeding is caused by dressings that stick when changed, soak the dressing off in clean water in the shower or with bottled saline for 10-15 minutes before gently removing.

❍ To prevent sticking ask your nurse to select a non-stick dressing.

❍ If bleeding happens with each dressing change, even if your dressing does not stick, your nurse can apply a specialized dressing (calcium alginate) under your dressing to help promote clotting



But First … Let’s Check in!

Sometimes a list of tasks can seem easy to do and because of that we can easily over commit. Look through the list and really think about the tasks you committed to. Ask yourself these questions;

  • Do these activities fit with my day to day activities?
  • Barriers are things that stand in the way of you being able to complete an objective. Can you think of any barriers that might prevent you from accomplishing them? An example might be I just can’t look at my wound.
  • Some of the barriers that prevent me from doing these things are: 
  • How can I overcome these barriers?
  • How confident am I that I can complete the tasks (0 is not confident at all and 10 is super confident)? 0 1 2 3 4 5 6 7 8 9 10

If your confidence score is less than 7, you might want to consider removing a ✓ mark or two. If your score is 7 or higher – give it a try!

After 2 weeks of trying to do these things reassess the list using the same process and if you feel confident enough, add a new task or two. Choose the tasks that are most important to you and you are most confident that you can complete. Remember - you do not need to accomplish this all on the first day – this is a journey! 


Is my Wound at Risk for Infection?

It is very important to prevent your wound from developing an infection.


There are many ways to reduce the risk of infection. Your nurse will teach you how:

  • To perform hand hygiene by washing your hands or using alcohol based hand rub before and after you do your dressing
  • To keep your dressing supplies in a clean container and away from pets


Your nurse has been trained to recognize the signs of infection. Some kinds of wound infection are called Superficial Infections.


This means that the germs are only on the surface of the wound. They won’t make you sick, but they can slow wound healing. You may see an increase in drainage, odour, pain or some redness around the wound, but you won’t have chills or fever because of it.


Superficial infection is managed with specialized antimicrobial dressings. Your nurse may decide to use one of these if they think your wound needs it. Your nurse will not take a swab when they determine that you have a superficial infection as swabs do not tell us if the wound is infected. We don’t use antibiotics for superficial infections.


Another, more serious kind of infection, is called Deep Tissue Infection. In this case the germs have spread to your body and are making you sick.


You may see redness and swelling spreading beyond the wound. The pain may increase, and you might have a temperature or have chills. This kind of infection needs a prescription for antibiotics. Your nurse will take a swab if they think that you have a Deep Tissue Infection so that your doctor will know what antibiotics will be effective. If you are given antibiotics be sure to take them as prescribed and finish them.


If you think you have Deep Tissue Infection you should see your doctor right away or go to the nearest Hospital Emergency.


How Does What I Eat and Drink Affect My Wound?

At this time in your life your body needs extra protein and vitamins and minerals. Even though you may find that you have decreased appetite and you may even find the smell of food unappealing here are some general guidelines to consider:


Here are Some General Guidelines to Consider:

  • Try to eat a variety of foods following Canada’s Food Guide 
  • Don’t skip meals, but eat less more frequently
  • Your body needs fluids. Try to drink 6-8 glasses of water or other fluids per day. Drinks with caffeine can cause you to lose fluids, so do not count them in your total
  • If you have been told to limit your fluid intake by your doctor, be sure you follow those instructions
  • If you are on a restricted diet for some other reason it could be hard to get all your nutrients. Consult a dietician or a nutritionist for more information
  • If you don’t feel hungry try to eat smaller meals more frequently
  • Weigh yourself once a week. If you are losing weight you may have trouble healing your wound so contact your doctor
  • Take a multivitamin
  • If you find it hard to eat a balanced diet, try a protein shake or buy a food supplement. There are some recipes in our Nutrition Guide.

Here are Some Examples of Nutrients in Foods:

Discuss these with your nurse. Identify the foods you will try to eat more often:



How can I Avoid Trauma to my wound?

Trauma can be anything that causes harm or injury to the area of the wound. Try to avoid:

  • Tight fitting shoes or socks if the wound is on your foot or toes,
  • Bumping your leg on furniture or car doors if the wound is on your leg,
  • Tight fitting clothes or belts if the wound is on your abdomen, or chest, and
  • Pets and kids bumping you or jumping on you and hitting your wound. Wounds can be easily damaged. Take care of your wound by protecting it from trauma. 



How to Change my Dressing


Check out this video that will show you how a simple dressing change is done. Your dressing change won’t be exactly the same, but it will be similar. 


You may be asked to purchase a few items for the nurse to use when doing your wound care and to keep these items clean. You will need to purchase disposable gloves for your care. To reduce the risk of infection to you, nurses do not carry scissors for use in your home as there is a risk that they may carry germs between patients.


Your nurse will provide you with sterile instruments that you will then keep clean for your use. This may include forceps, scissors and a probe. Be sure that you or your nurse only use these instruments for your dressings. Your nurse will show you how to change your dressing and tell you how long to keep the dressing on between changes. They will recommend specific products.


6 Steps to Change Your Dressing

  1. Prepare the area where you will do the dressing change
    • You will need a clean spot to do your care with good lighting. Remove kids and pets from the area. 
  2. Gather your supplies
    • Alcohol based hand cleaner for your hands

    • Non-sterile gloves (at least 2 pair)

    • Adhesive remover

    • Gauze pads

    • Sterile normal saline cleanser

    • No sting barrier film nor skin prep

    • Tape

    • Plastic sealable trash bag

    • Clean towel to absorb cleansing solution

    • Scissors

    • Dressings 

  3. Remove the old dressing
    1. Clean your hands with soap & water or an alcohol-based hand rub.
    2. Put on the gloves
    3. Slowly lift the corners or edge of dressings, if it is sticky use the adhesive remover to loosen.
    4. Hold down the skin and pull tape across the skin rather than pulling. If you have an adhesive dressing, anchor the dressing with one hand and stretch it away from the wound to loosen it. Do not tear your skin.
    5. Throw away the used dressings in plastic bag.
    6. Remove your gloves and clean your hands again. 
  4. Cleanse the wound
    1. Put on new gloves
    2. Place a towel under the wound.
    3. Cleanse the wound with the saline the way your nurse showed you.
    4. Use gauze to blot the surrounding skin around the wound.
    5. Discard used gauze into the plastic bag.
    6. Check the wound for redness, drainage, swelling or odour. 
  5. Apply the new dressing
    1. Open new dressing & remove from the package. Only touch the corners.
    2. Apply skin barrier or skin prep to the skin around the wound.
    3. Center dressing over wound.
    4. Secure with tape or, if the dressing is adhesive, smooth out the adhesive borders.
    5. Discard packaging into plastic bag and seal the bag.
    6. Remove gloves, wash your hands.
  6. Cleanse your equipment

How to Clean your Equipment

Each time after wound care is completed, follow these directions to clean the instruments:

  1. Fill a clean bowl with warm water and add dish soap,
  2. Wash each instrument in the warm water removing anything visible,
  3. Rinse the instruments under the tap with warm running water,
  4. Lay instruments on a clean towel or paper towel and air dry them,
  5. Once the instruments are completely dry, put them in a clean, plastic container with a lid or a clean, sealable plastic bag,
  6. Close the lid of the container or seal the bag,
  7. When it is time to do your wound care, remove the instruments from the container or bag and complete your wound care,
  8. Repeat the cleaning procedure each time wound care is completed,
  9. Once the wound is closed and no more wound care is required, safely dispose of the instruments



When to Call your Nurse.

If any of the following occur:

  1. Increased pain at wound site,
  2. Unexpected bleeding (for severe bleeding use a towel to absorb and apply pressure; go to the emergency of your local hospital),
  3. Redness or swelling around wound or spreading out,
  4. Warmth around the wound site,
  5. Foul odor from wound after you have cleaned it,
  6. Change in colour or amount of drainage,
  7. Fever chills or nausea. 



I am ready for Discharge: What do I need to know?

You and your nurse have agreed that it is time to discharge you because you have a routine to care for your wound and because you now have the knowledge and skill to look after it yourself or with help from your significant other. Always protect the area from pressure, trauma and other forms of injury. If you are doing your dressing changes, follow your nurse’s instructions. See the section on How to Change my Dressing above. 


Glossary of Terms

Antimicrobial dressings: are used to reduce the number of micro-organisms in the wound which reduces the risk of infection.

Autolytic debridement: uses the body's own enzymes and moisture to re-hydrate, soften and finally liquefy hard eschar (scab) and slough (wet dead tissue) in the wound. Only dead tissue is liquefied. It is virtually painless for the patient.

Conservative sharps debridement: conservative sharp wound debridement (CSWD) is the removal of loose avascular tissue without pain or bleeding.

Deep tissue infection: infection in a wound that has reached the deeper layers of the body. A deep infection means that the whole body is infected, not just the wound and oral or IV antibiotics are needed for healing.

Germs: microorganism, especially one that causes disease.

Hand hygiene: cleaning hands to remove soil, dirt, and germs. If water and soap are not available, hands can be cleaned with alcohol based hand rub.

Healable wound: a wound that is ready to heal and all the patient factors make it able to heal; these factors include circulation, diet, devices etc.

Maintenance wound: a wound where healing has stalled due to factors that need to be corrected such as blood sugars in the person with diabetes or the purchase of specific equipment or perhaps remedial surgery.

Non-healable wound: a wound that cannot heal due to factors that cannot be corrected such as poor circulation.

Offload:  Removing pressure from an area that is at risk of wounding or has a wound

Superficial infection: A wound infection that is localized to just the wound. The body is not infected and the patient does not need systemic antibiotics to heal.