Skin Mets

From the BCMets The Book of Knowledge

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Symptoms of Skin Mets

Skin mets usually begin on or near the scar line. Symptoms are listed below in the order they are reported to occur.

  • warmth
  • itchy places
  • thickening or hardening
  • pink or red blotches (called Patchy Erythema)
  • stinging that comes and goes
  • rough or slightly raised areas in the pink patches (also described as shiny spots)
  • small nodules appear

Nodules are tiny bumps just under the skin. They look white and sometimes have pinkish skin around them. They feel like a grain of sand if found early. To see pictures of the nodules go to: http://www.ibcsupport.org/pictures/skinmets.htm

Some comments:

  • looks like a pimple but hard
  • a grain of rice
  • tiny slabs of cement
  • a cauliflower growing under skin
  • looked like a flat squashed pimple
  • about the size of the letter o

The pinkness can become red in stripes or blotches that eventually merge. It has been described as looking like broken blood vessels, small red dots, marks left on skin when tape is removed, poison ivy or eczema, and reddish blotches with purple bruising

Some patients report occasional stabbing pain, a punched feeling, a burning sensation, or prickly irritation.

As the skin mets progress the skin begins to breakdown and become weepy. A report from one such patient is very informative:

The weeping begins as a slow process. In the beginning there are one or two "tear drops" that run from the breast/chest downward. The colour is a clear pinkish and/or yellowish depending on how much blood may accompany the weeping. For me, I had no blood accompaniment for a long time.
As time went on, more of the tumors started to erupt which included both bleeding and weeping. The "tear drops" were a little redder and there were more of them flowing from the cancerous spots. This is when the weeping became a big problem and introduced me to the world of "dressings". The wetness was so severe that it went through my clothes, onto my bedsheets, etc., etc. Even now, the weeping is to an extent that special dressings (similary used in surgery to stop the flow of blood) is used and the watery weeping completely saturates the dressing.
By the way, I had an indication of infection when the weeping began to smell. My doctor gave me "Metro Cream" to help me clear this up. I now take two baths per day just before changing my dressings.
I have had several opinions from the nurse regarding the frequency of usage. At first I was told to change my dressings only once every 24 hours. I screamed loudly because this meant that I could not leave the house for very long without getting my clothes (primarily waist area) all wet. Three nurses came to the house to examine me and it was agreed that I could change dressings once in the a.m. and once in the p.m. So if you ever get to the stage that I am at (I hear everyone is different) scream until you get what you need.
In addition to the pinkish/clear liquid there is often little breaks in the skin or patches where the skin disappears and it is in these areas that I bleed. Some of my dressings are specifically to stop the flow of blood.


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Treatment of Skin Mets

Two basic ways -- locally and systemically. Many patients have both. The goals of therapy in metastatic disease are palliation of symptoms and prolongation of life.

Local treatments include ElectronBeam radiation, surgery, burning or freezing lesions, topical chemotherapy, Photodynamic Therapy and Hyperthermia.

One promising topical treatment is Miltex made by Asta Medica. Presently available in Germany, France, Spain, Brazil and soon to be approved in Great Britain. Miltex can be obtained in North America through a Compassionate use program which is described at: http://breastcancer.about.com/library/drugs/blMiltex.htm?once=true&

Here is an abstract from the American Journal of Clinical Oncology Nov. 2001 about a phase 3 study done in Great Britain: http://www.jco.org/cgi/content/abstract/19/21/4150

Here is an abstract of a phase III study from 1999 http://www.asco.org/prof/me/html/99abstracts/bc/m_481.htm

Systemic treatments are the same as for other mets: chemo, hormonal treatments and experimental vaccines, antibodies etc.

Since skin mets can cause pain and itching, often other drugs are needed for symptom relief.

Treatment site for Thermoradiotherapy Treatment For Localized Inflammatory Breast Cancer can be found at http://vci.org/inflamma.htm

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