Ulcerating cancer wounds
Ulcerating cancer wounds are rare. They develop when a tumour breaks through the skin.
What are ulcerating cancer wounds?
An ulcerating cancer wound is when a tumour grows and breaks through the skin, creating a wound. Doctors sometimes call them fungating cancer wounds or malignant wounds.
When a tumour grows, it can block and damage tiny blood vessels. This can reduce the supply of oxygen to the area. This causes the skin and the tissue underneath to die. The wound may then become infected and ulcerated.
Ulcerating cancer wounds are rare. Most people with cancer never develop one. They are more likely to happen in advanced cancer. And they are most likely to happen in cancers that develop in the skin or close to the skin – for example, melanoma, breast cancer and head and neck cancer.
An ulcerating cancer wound can develop in:
- the area where the cancer started (the primary site)
- a part of the body where the cancer has spread to (a secondary cancer or metastasis).
Symptoms of ulcerating cancer wounds
The most common symptoms of ulcerating cancer wounds are:
- leakage or discharge
- bleeding
- an unpleasant smell
- pain
- itching.
Treating ulcerating cancer wounds
If you have an ulcerating cancer wound, you will be supported by your healthcare team in hospital and in the community. The team can include:
- your cancer doctor
- your GP
- hospital and community palliative care teams
- cancer nurses, such as a clinical nurse specialist or palliative care nurse
- district nurses (community nurses) or a practice nurse
- specialist nurses in wound care (often called tissue viability nurses)
- other healthcare professionals, such as a pain specialist nurse.
Your healthcare team will help you to manage the wound so that you can get on with your day-to-day life.
Your GP or cancer specialist can refer you to a palliative care team for supportive care. This is a team of doctors, nurses and other professionals who will help support you and make sure your symptoms are controlled. They will work with you, your carers, your GP and other health professionals.
Your hospital and community nurses can give you advice about how to care for the wound. They can explain how the symptoms can be controlled. They may give you dressings or creams to keep at home. You should only use dressings or creams that are recommended or given to you by your nurses.
Treating the cancer
An ulcerating wound is caused by the tumour. Treatments that help control the tumour may also help reduce the wound and improve symptoms.
Treatment will depend on:
- the type and size (stage) of the cancer
- where the wound is
Cancer treatments include the following:
-
Radiotherapy
Radiotherapy treats cancer by using high-energy rays to treat cancer cells. It targets the cells in the area to reduce the damage to the surrounding skin and tissue. It can be used to control symptoms such as pain (palliative radiotherapy). It can sometimes shrink the tumour and reduce leakage, discharge or bleeding.
For a short time after radiotherapy, you may find your symptoms become worse. The skin around the wound may redden or darken. It may become dry, feel sore or feel itchy. Tell your specialist nurse or radiographer if your skin becomes sore or itchy or changes colour. They can give you advice and treatments if
-
Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is used to help shrink the tumour and reduce any symptoms. It may take some time before any effects of chemotherapy are seen on the wound.
-
Electrochemotherapy
Electrochemotherapy uses a combination of chemotherapy and a small electrical current to treat cancer cells that have spread to the skin. It does not treat the cancer elsewhere in the body. It can help shrink the tumour and reduce pain, leakage, discharge and bleeding. The doctor injects a low dose of chemotherapy into a vein (intravenously). After this, they put a probe (electrode) directly over the tumour to give an electrical pulse. The pulse changes the outside layer of the cells. This is called electroporation. It helps the chemotherapy reach the cancer cells in that area.
-
Hormonal therapy
SHormones can cause cancers such as breast cancer or prostate cancer to grow. Hormonal therapies reduces the level of hormones or blocks them from the cells. This can slow the growth of the cancer and help improve symptoms. It may take some time for hormonal therapy to improve an ulcerating cancer wound.
-
Targeted therapy and immunotherapy
Targeted therapy targets something in or around the cancer cell that is helping it grow and survive. There are different types of targeted therapy. Immunotherapy uses the immune system to find and attack cancer cells. Targeted therapy and immunotherapy might help shrink the tumour and reduce any symptoms. It may take some time for targeted therapy or immunotherapy to improve an ulcerating cancer wound.
-
Surgery
Depending on the size and position of the tumour, it may be possible to remove part or all of it with surgery. Sometimes skin needs to be taken from another part of the body to cover the area where the tumour is removed. This is called a skin graft. Because ulcerating wounds often cause damage to blood vessels, there can be a risk of bleeding, so surgery is not always possible.
Treating the symptoms of ulcerating cancer wounds
Ulcerating cancer wounds do not usually heal completely. Cancer treatments may help reduce the size of the wound, but the main aim of treatments is to improve symptoms.
Leakage
Leakage or discharge is probably the most common symptom of an ulcerating wound. It often happens because of an infection in the wound.
The discharge or leakage can make the skin around the wound sore and red. You can use barrier cream to help protect the skin. Your nurses can explain how to use it. They may give you the cream or advise you about a suitable type to get.
Your nurse may suggest showering with warm water to help clean the wound and reduce any smell. It is important to ask the nurses if you can shower your wound because it is not always advised. They can give you advice about shower gels and soaps.
Bleeding
Bleeding from the wound is a common problem. But there are things that can help.
Wounds may bleed if the tumour has damaged the small blood vessels. It can also happen if cancer treatment has reduced the number of platelets in your blood. Platelets help your blood to clot.
It is important to tell your doctor or nurse if you notice any bleeding, or a change in the amount of bleeding.
Bleeding sometimes happens when changing the dressing over the wound. Non-stick dressings can help reduce this. The nurses can also use dressings that contain a gel to help prevent and absorb bleeding.
There are also medicines the nurses can apply to the wound that reduce or help prevent bleeding.
Sometimes the blood vessels can be sealed (cauterised) using silver nitrate. Cancer treatments such as radiotherapy or electrochemotherapy can help control bleeding.
If you have heavy bleeding that does not stop after 15 minutes, apply a dressing pad and pressure to the wound. You should go to the hospital straight away. You, or someone with you, should call 999 for an ambulance.
Unpleasant smell
An unpleasant smell (odour) from the wound is a common symptom. It can be distressing and difficult to cope with. Sometimes the smell is caused by an infection in the wound. There are things that can help.
If it is caused by infection, antibiotics can help. Antibiotic gel can also be applied to the wound.
You may feel self-conscious about a smell, especially when you are with other people. There are ways to hide smells. These include:
- air fresheners
- odour neutralisers
- environmental air filters
- aromatherapy oils.
Do not put oils or products directly on your wound, dressings or clothes. Your nurse can give you more advice about the best way to use them.
Dressings for ulcerating cancer wounds
There are different types of dressing for different types of wound. Your practice nurse or district nurse can change the dressings. They might vary the type of dressing to find one that works best for you. Dressings are used to:
- protect the wound
- keep the wound clean
- absorb discharge and bleeding
- help prevent any smell.
Depending on symptoms, the nurse may leave a dressing on for a few days. Or they may only change the top layer. They may put additional padding on top of your dressing in case of any leaks. They may also suggest you put disposable sheet pads on your bed. This is to protect your bedding.
To help with discharge and bleeding, the nurses might use dressings that:
- are very absorbent
- contain a gel that absorbs discharge or blood.
If there is a lot of discharge, they might suggest attaching a bag.
There are special dressings that do not stick to the wound. Some dressings contain medicine that helps stop bleeding. This is called a clotting agent.
Some dressings are designed to form a seal and absorb smell. They contain charcoal. Some dressings are perfumed.
Dressings containing silver and a medical type of honey can also help with smell. This is because they prevent bacteria from getting into the wound.
If the wound is in an awkward place, such as in your armpit or groin, it can be difficult to find the right size and shape of dressing. It can be hard to keep it in place. You could try the following:
- Use a support bandage or garment – for example, Tubifast™, Comfifast™ and Skinnies WEB™. Your nurse can give you more information about these.
- Wear Lycra® clothing, such as crop tops, t-shirt vests or cycling shorts. This helps to keep a dressing in the right position under clothing.
You can get advice about these products, and where to get them, from your specialist nurse.
Pain
Ulcerating cancer wounds can press on nerves, which can cause pain. Having your dressing changed can be uncomfortable too. But there are things that can help.
You can use different types of painkiller depending on your situation. Regular and longer-acting painkillers can help to keep you comfortable day-to-day. You may need extra short-acting painkillers when you have your dressing changed. Your nurse may be able to soak off the dressing. Or they can use special non-stick dressings to help reduce any discomfort when they are removed.
If changing the dressing causes a lot of pain, the nurse may talk to you about having nitrous oxide (Entonox) if they think it might be suitable. You breathe in Entonox through a mouthpiece that you hold. It is the same gas and air that people use during childbirth.
Tell your doctor or nurse if your pain is worse than usual. It might mean there is an infection that needs to be treated.
Itching
You may have itching around the wound. This can happen if the skin is stretched or the nerve endings are irritated. Tell your healthcare team so they can support you and suggest things to help. Antihistamine tablets, which are normally used for itching, do not always work. Your doctor may prescribe a steroid cream if they think it could help.
The following may relieve itching:
- dressings that keep the skin well hydrated – these are called hydrogel sheets
- moisturising creams, such as E45®
- cotton bedding and clothing.
If itching does not improve, your doctor or nurse may suggest using a TENS machine. A TENS machine stimulates nerves that carry non-painful messages to your brain. They are thought to block messages from being carried along the nerves to the brain. They can also make the body release its own painkillers (endorphins).
If you are allergic to any dressings or adhesives, it is important to tell your nurse or doctor as this may cause itching.
Your feelings about ulcerating cancer wounds
You may struggle with your emotions when you have an ulcerating cancer wound. You may feel anxious or depressed because of the wound. Some people feel embarrassed and worry about leaving the house. This can lead to feeling lonely and isolated. It is important to remember that you will be much more aware of the wound than other people.
How you think and feel about your body (your body image) may change. You may also worry about the effects on your close relationships. We have more information about body image and cancer. We explains the types of support you can get and has suggestions about what you can do.
Talk to your family and close friends about how you feel. They can listen and give you support. We also have information about people who are looking after someone with cancer that they might find helpful.
Support groups, counselling and complementary therapies, such as relaxation and aromatherapy, can also be helpful. Our cancer support specialists can give you details of support organisations and counselling services in your area. Call us free on 0808 808 00 00 or chat with us online.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
-
References
Below is a sample of the sources used in our ulcerating cancer wounds information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Morley J, Grocott P, Purssell E, Murrells T. Electrochemotherapy for the palliative management of cutaneous metastases: A systematic review and meta-analysis. Eur J Surg Oncol. 2019 Dec;45(12):2257-2267. doi: 10.1016/j.ejso.2019.07.003. Epub 2019 Jul 2. PMID: 31285093.
NICE. Palliative care – malignant skin ulcer. Last revised April 2025. Available at Palliative care - malignant skin ulcer | Health topics A to Z | CKS | NICE (accessed October 2023).
NICE, Electrochemotherapy for metastases in the skin from tumours of non-skin origin and melanoma Interventional procedures guidance [IPG446] Published: 27 March 2013 www.nice.org.uk/guidance/ipg446 (accessed October 2023)
Date reviewed
Our cancer information meets the PIF TICK quality mark.
This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.