Four ‘noxious’ odours seen in terminal cancer patients

Skin cancer: Dr Chris outlines the signs of a melanoma

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Cancer patients receiving palliative care generally suffer from a tumour that has spread beyond the control of treatment. At this stage, end-of-life care focuses on alleviating the symptom burden of patients. Carers, however, sometimes struggle to cope with unpleasant odours resulting from “superinfections” and discharge.

Malodorous patients in the terminal stages of cancer have often proved a challenge for caregivers, according to the Journal of Palliative Care.

The journal explains: “Whatever the cause of primary cancer, three sources of noxious odour can exist or coexist, (including) necrosis, superinfection and perspiration and/or discharge.”

In necrosis, the smell tends to reflect dead or necrotic tissue or bacteria within a wound, which can give off a smell comparable to that of rotting meat or rotting fruit.

To prevent further infection, experts advise anyone with an unpleasant smell coming from an open sore to seek medical care from a doctor.

In most cases, a course of antibiotics will suffice to clear up the infection, but more rigorous measures could be warranted to remove dead tissue from the affected area.

In cancer, a superinfection is generally defined as an infection occurring during a course of antibiotics, or within a week of discontinuing antibiotic therapy.

As a preventive measure, any patient suffering from a smelly wound is encouraged to seek treatment from a doctor, or else symptoms could advance.

Though these symptoms occur with all types of cancer, those that are most likely to exhibit symptoms on the epidermis are different skin cancers.

Although infected moles are not a common feature of skin cancer, they can occur in severe forms of the disease like melanoma.

In metastatic melanoma, the disease often spreads internally to organs, but some cases have infected tissue that mimics fungal infections.

In the initial stages, the most frequently encountered sign of skin cancer changes to existing freckles and moles or new ones appearing.

Moles and freckles contain cells known as melanocytes, which are responsible for producing concentrated areas of melanin – the skin’s pigment.

When melanocytes are damaged by the skin, they turn into cancerous cells which may produce strange signs like bleeding.

Doctor Ross Perry, of the skin clinic chain Cosmedics, said: “70 percent of melanomas are a new mole, and that is why it is always important to be vigilant and check regularly for new moles, but also changing moles or abnormal moles.”

The expert continued: “Skin cancer often occurs in two forms. You have the melanoma type of skin cancer which is often the most worrying and the one that has the highest risk of spreading to other parts of the body.

“Non-melanoma skin cancer, which is another type of skin cancer, is directly related to sun exposure and […] topically occurs in our 50s, 60s [and] 70s.

“However this is a less aggressive form of skin cancer and is not so much of a mole but is more a sort of red patch of a lump in the skin that can often be painful, itch or bleed.”

In 2008, Michelle Gallagher, PhD, George Preti, PhD and colleagues reported that different types of skin cancer may exhibit “distinct smell” profiles.

According to the experts, this key characteristic of the disease is determined by organic chemicals released by the skin, which humans cannot pick up.

Thanks to several studies, however, researchers later established that dogs have the ability to sniff out melanomas and other cancers.

Anyone who notices a suspicious mole or malodourous ulcer is advised to undergo a biopsy in order to rule out the possibility of cancer.

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