USE OF METRONIDAZOLE GEL TO CONTROL MALODOR IN ADVANCED AND RECURRENTBREAST-CANCER

Intolerable malodor emanating from ulcerated tumors as a result of ana erobic infection is a serious problem in the management of advanced an d recurrent breast cancer. Metronidazole can control this malodor, but its oral use may cause adverse reactions. We therefore formulated a m etronidazole gel, since no equivalent preparation is commercially avai lable in Japan, and used it in five female patients (four with advance d cancer and one with recurrent cancer) admitted to our hospital betwe en March 1994 and July 1995. The patients were aged between 47 and 71 (median: 59) years, and the duration of morbidity in the four patients with advanced cancer ranged from 10 months to four years. In three pa tients, the tumors were larger than 10 cm x 10 cm. Metronidazole gel w as applied to the surface of ulcerated tumors once or twice daily. Ind ependent assessments by the patient, doctor and nurse were unanimous, and revealed that the malodor was alleviated in one patient after thre e days, and removed in four patients after two to five (median: four) days of metronidazole gel treatment. Culture of swabs showed a decreas e or disappearance of anaerobic colonies. Adverse reactions characteri stic of metronidazole did not occur. The topical use of metronidazole in a gel form will improve the quality of life for patients with malod orous ulcerated tumors and facilitate intensive treatment of the under lying disease.