Assessing Quality of Life in Patients with Malignant Wounds Treated at a Dedicated Clinic
Patients with advanced cancer can experience malignant wounds, which can have a negative impact on quality of life.
Patients with advanced stage cancer who have malignant wounds can experience a significantly increased quality of life if they are treated at a dedicated wound clinic, according to recent data presented at the American Society of Clinical Oncology 2024 Annual Meeting, held May 31 to June 4 in Chicago, Illinois.1
Assessing Quality of Life in Patients with Malignant Wounds Treated at a Dedicated Clinic / C Davids/peopleimages.com - stock.adobe.com
Malignant wounds impact between 5% to 10% of patients with advanced cancer and can be a serious complication of the disease.2 The wounds often present as crater-like ulcers or raised nodules and are associated with edema, necrosis, pain, bleeding, and infection. Patients with malignant wounds can experience a negative quality of life, but there is currently a lack of data on if being treated in a dedicated wound clinic can help.
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Investigators from the Memorial Sloan Kettering Cancer Center in New York City conducted a retrospective study to assess the effect of wound care clinics on quality of life in patients with malignant wounds. Data for the study were collected from electronic medical records from the hospital.
The study cohort included 36 patients who were treated at a wound care clinic between January 2016 and March 2023. Patients completed at least 1 Skindex-16 questionnaire, which is a validated measure of the effects of skin diseases on quality of life. Of the patients, 9.7% were stage 2, 41.9% stage 3, and 48.4% stage 4. Fifty percent of the patients developed malignant wounds from metastatic breast cancer, 22.2% developed them from cutaneous squamous cell carcinoma, and 27.8% developed them from other forms of malignancies, such as sarcoma.
At their first visit, patients had drainage associated with their wound 86.1% of the time, odor 47.2%, bleeding 63.9%, pain 69.4%, and itch 50%. All of the patients were treated with dressings, 88.2% received topical treatment for odor, 73.9% for bleeding, and 55.6% for itch. For pain, 36% received gabapentin and 24% received an opioid. The median Skindex-16 score at baseline was 59.5, which represents “extremely severe.” The median scores for the symptom, emotion, and function domains were 17.5, 21, and 23, respectively.
Investigators found that, of 19 patients who completed questionnaires at follow-up visits, there was a 34.5% improvement in quality of life at visit 2, 45.4% at visit 3, 73.1% at visit 4, and 83.2% at visit 5 or more.
“Malignant wounds severely reduce patients’ quality of life; however, patients experienced significantly improved quality of life after being treated at dedicated wound clinics,” the authors concluded.
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