Bed sores develop when an area of the body loses blood supply, leading to the death of the skin and an ulcer or pressure sore. One potential outcome of a bed sore is a type of skin cancer known as squamous carcinoma. This is a rare occurrence, and scientists are still researching the connection between bed sores and cancer to better understand this risk. However, it does happen to some patients, possibly due to bed sores permanently altering cell structure.
Skin cells need a constant flow of blood supply to survive. Usually, the blood carries important nutrients and fresh oxygen to the cells throughout the body. It also carries away a working cell’s waste products, keeping the cells healthy. When prolonged pressure to one area of the body cuts off blood supply to skin cells, they can suffer damage or die completely. This leads to bed sores, or injuries to the skin and underlying tissues. Bed sores can cause red areas, swelling, tenderness, and pus-like drainage from the skin.
Bed sores are treatable, but can be life-threatening without prompt treatment. Dangerous complications include serious infections, sepsis, cellulitis, and cancer. Most serious complications arise when a patient’s bed sores go untreated, and become long-term non-healing injuries. Failure to properly treat a bed sore could lead to lasting changes to the skin cells. Scientists and doctors believe it is these cell changes that culminate in the presence of squamous cell carcinoma in some patients.
Squamous cell carcinoma (SCC) is the second-most common type of skin cancer. It refers to the growth of abnormal cells in the skin’s outermost layer, or the epidermis. SCC can happen anywhere on the body, but is most common in places often exposed to the sun. Sun damage could lead to SCC. Squamous carcinoma can look similar to a bed sore, potentially leading to a patient or caregiver confusing the two. SCC can take the appearance of open sores, scaly patches of skin, or elevated growths. Some may form a crust or break open and bleed.
Although not usually life-threatening, without proper diagnosis and treatment a squamous carcinoma can be deadly. SCCs can grow larger without treatment and cause health complications. It could kill healthy tissue near the growth, as well as spread to the lymph nodes or organs. The most dangerous squamous carcinomas are large or those that involve mucous membranes (e.g. on the lips). Someone with a weak immune system could also be at greater risk of a fatal SCC.
One study in 2015 examined the transformation of long-standing bed sores into squamous cell carcinoma. The report states that chronic inflammation is a known risk factor for SCC. Recurring bed sores can cause chronic inflammation, and thus can increase the risk of developing SCC. The study explains the potential risk of Marjolin’s ulcers in particular, or a type of squamous carcinoma that results from previously traumatized or degenerated skin. The lasting damage chronic bed sores can inflict on the skin could be enough to lead to Marjolin’s ulcers in the patient.
Scientists have yet to define the exact mechanism for why Marjolin’s ulcers develop. However, they know most cases occur in patients with burn scars, osteomyelitis (bone infections), and diabetic ulcers. Chronic skin irritation can also increase the risk of the skin cells undergoing malignant change. The development of cancer after a bed sore is rare, occurring about 0.5% of the time, according to the study. If bed sores go untreated, recur in the same patient, or transform into complications such as bone infections, however, they could potentially cause cancer. Prompt bed sore diagnosis and treatment could help prevent the development of cancer.
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