draining tumor

[whimzy]

I have a locally advanced IDC in my right breast.  The tumor is open to my skin and constantly draining fluid.  This fluid is not pus.  It's thin and for the most part, clear, and not malodorous.  The chemo that I've had so far has reduced my tumor somewhat and now the doctor says that we need to heal the opening in my chest, which is about 1.5 inches long and .5 inches wide.  She says I need to keep it dry, but how can I do this?  The tumor produces A LOT of fluid, and I have to change the dressing 4 times a day. It has been "draining" since March.  Is this fluid produced by my lymph nodes and why is the tumor producing this fluid?  Is this an indication that there is cancer in my lymph nodes and that they are not draining as they should?  If the wound on my chest heals up, then there will be no way for the fluid to drain.  Wouldn't that be bad?  I hope that you can answer these questions for me. Thanks!

[whimzy]

Thanks doctor for coming back and adding.  I really appreciate what you said, especially there at the end.  It's bad enough having to deal with having cancer and going through chemo without all this darn drainage.  Thanks also for your comments CCF-RN.  I'm doing my best to keep it dry.  I use sanitary napkins and change them every 2 hours or so.  No problems with infection right now, though did have early on.

[whimzy]

Thanks for your reply, Doctor.  So far I have received 4 taxoteres.  The first one worked and shrunk my tumor from 9.5 cm to 5.5 cm, but the consequent treatments have had little effect and I feel like my tumor is growing again.  The doctor said that they would try another chemo for more shrinkage before a mastectomy.  I just don't understand why it's so important for the skin to heal over as this would block off the drainage, which seems to have no where else to go.  I feel like my breast would probably swell up with fluid.  My prognosis doesn't look too good, does it?

[surgeon]

You describe a difficult problem. It could be that there's lymphatic obstruction. Whatever the reason, getting it to heal would require much more than local care. I assume you are being managed by a breast surgeon among others; if not, you ought to be unless you've refused such care. Optimum treatment of locally advanced tumor requires, in most cases, a properly timed combination of chemotherapy, radiation therapy, and surgery.

[surgeon]

The more shrinkage the better; but at some point the surgery will need to be done, and it may well not be possible to dry it up beforehand. Prognosis is hard to judge; even with advanced local disease, there's other info needed. And it's sometimes true that those tumors which develop so extensively locally do so because they don't spread as rapidly elsewhere. Obviously it's better in terms of prognosis to get treatment before it gets to this stage; but one would still go into treatments with the reasonable goal of living with or without tumor for many years.

[CCF-RN,MSN-rf]

Dear whimzy:  You are right.  It will be difficult to heal this while it is draining as much as you describe.  This fluid could be lymphatic but regardless the treatment plan would, in all likelihood, include surgery at some point.  This may be the opportunity to "heal" the wound.  In the meantime, the goal would be to keep the wound as dry as possible to prevent the surrounding skin from being irritated and breaking down and also to prevent infection.