Sweat gland cancer, a rare disease, according to global medical literature, had only 48 reported cases worldwide as of 1976, and now it has been identified in Vietnam. In the southern region alone, there are currently 4-5 cases reported, with the initial symptom being a “hard lump in the skin“.
Today, alongside common cancers such as lung, liver, throat, esophagus, colon, and stomach cancers, sweat gland cancer (SGC) may seem unfamiliar! However, in recent years, a very small number of unfortunate patients have emerged in southern provinces and cities. If not detected early and treated with appropriate protocols, the risk of death is significantly high.
Sweat gland cancer is so rare that even some oncologists express surprise when this condition is mentioned…
From a “hard lump in the skin“…
To help understand this disease, Dr. Bui Chi Viet, Deputy Head of the Surgery Department 2 at Ho Chi Minh City Oncology Hospital, diligently revisited the medical records of hundreds of patients at the hospital over the years.
The archived records indicate that from 2002 to present, there have been only 4 cases diagnosed with sweat gland cancer: in 2002, Ms. Ngo Thi Luong (born 1977, Phung Hiep, Can Tho); in 2003, Mrs. Tran Thi Duc (born 1945, District 4, Ho Chi Minh City); and in 2006, two cases, Mr. Tran Hong Tho (born 1969, Mang Thit, Vinh Long) and Mr. To Mao (born 1937, Phan Thiet, Binh Thuan).
All four cases mentioned above had a “hard lump in the skin” located on the lower leg, thigh (either right or left), and shoulder. Among them, patient Tran Hong Tho initially presented with a lump on his left lower leg, but after 5 surgeries and 10 sessions of ionizing radiation therapy, he finally stabilized after a follow-up visit in March 2007.
One notable case is that of a female patient named Nguyen Thi Thuong (born 1952, Tan Thien, Ham Tan, Binh Thuan), who has since passed away and is not recorded in the surgical department’s archives at Ho Chi Minh City Oncology Hospital. The author of this article independently sought information regarding her case from her treating physician and family.
Despite treatment, the recurrence rate remains high: 59%
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A patient undergoing treatment at Department of Internal Medicine 1 – Ho Chi Minh City Oncology Hospital (Photo: H. Cat) |
Accordingly, in September 2001, Ms. Thuong, at the age of 49, visited the Ho Chi Minh City Oncology Center (now Ho Chi Minh City Oncology Hospital) with initial symptoms of a lump located at the back of her neck near the nape, causing pain. Previously, since it was not painful, Ms. Thuong did not pay much attention, but after a short time, when the lump swelled to about the size of a chicken egg, she began to feel discomfort and pain in her back.
After a diagnosis through histopathology, confirming the malignancy level through biopsy, the doctors diagnosed Ms. Thuong with sweat gland cancer in the back region.
Her family was devastated upon hearing this news, as they had thought it was merely a “normal lump” on the skin and had not been concerned, questioning how a “sweat gland” could develop cancer. When they consulted the treating physician, they were informed it was a “rare disease.”
Subsequently, Ms. Thuong was scheduled for surgery and underwent radiation therapy. After approximately 4 months of treatment, she was discharged and fully recovered. With her health restored and the tumor completely removed, she felt at ease living with it.
Unfortunately, she fell into the 59% recurrence rate… Just three years later, in 2005, she suddenly felt fatigued, lost her appetite, and experienced frequent insomnia, particularly severe pain in her spine. Ms. Thuong suspected she had spinal osteophytes, but tests yielded no results.
What Ms. Thuong did not realize was that although the tumor had been removed before, it had now recurred and metastasized to the bones. As Dr. Bui Chi Viet explained, once all the abnormal tissue is removed, the edges of the specimen must also be carefully examined to ensure that malignant tissue has indeed been completely excised. If cancer spreads to other vital areas of the body (metastasis), surgery at this stage is merely “fire-fighting,” if not entirely pointless.
Indeed, after returning for a follow-up visit at Ho Chi Minh City Oncology Hospital, the doctors there were still unsure whether Ms. Thuong had cancer again. They had to wait for a CT scan of the lumbar region, costing 1,000,000 VND per session at Cho Ray Hospital, to confirm that she had metastatic sweat gland cancer. At this point, the family requested the hospital to perform surgery in hopes of prolonging her life, but it seemed that everything was too late.
Initially, it was just a small lump on her back that went unnoticed, but when it recurred and invaded her bones, Ms. Thuong experienced severe pain, complete insomnia, and had to rely on powerful painkillers such as Cyclohexanol 50 mg or Tramadol, a narcotic containing Morphine. This medication is only to be used under a physician’s direction to alleviate pain in the body.
At that time, conventional medicine seemed powerless… Ms. Thuong was compelled to seek out traditional medicine in hopes of finding a miracle.
However, after more than six months of searching for treatments and outpatient care at Cho Ray Hospital and Ho Chi Minh City Oncology Hospital, Ms. Nguyen Thi Thuong passed away in May 2006. At that time, her weight had dropped to less than 37 kg!
Ms. Nguyen Thi Thuong is recorded as the first patient to die from sweat gland cancer in the back region in at least the last five years.
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Sweat Gland Cancer Sweat gland cancer (SGC) initially presents as a small lump on the thigh, lower leg, shoulder, or back that seems unimportant. Many consider it merely a benign tumor, but later the lump may suddenly increase in size, causing discomfort and pain. Although surgery to remove the tumor in the early stages, along with chemotherapy and radiation therapy, is regarded as the most effective treatment protocol, the mortality risk for this disease remains high due to a recurrence rate of 45-59%! According to Dr. Bui Chi Viet, a characteristic of sweat gland cancer is that there are no specific clinical diagnostic images; it typically manifests as hard lesions, burning, or ulceration on the skin’s surface, appearing red to dark purple, and can sometimes occur on the upper limbs, lower limbs, vaginal area, or around the anus. The tumor grows slowly and then suddenly increases in size, invading surrounding skin structures and metastasizing to bones, lungs, and rarely to the brain or kidneys. When treated, the typical approach is extensive surgical excision along with lymph node management if metastasis is present. However, the recurrence rate of this disease ranges from 45-59%, making it challenging to predict what will happen to those affected by this illness. Meanwhile, Dr. Doan Huu Nam, Head of Planning and General Department at Ho Chi Minh City Oncology Hospital, added that the hospital receives around 30,000 cases of various cancers each year. In 2006 alone, there were 859 cases of malignant skin tumors, among which sweat gland cancer falls under the category of skin appendage cancers, including hair follicle cancer, sebaceous gland cancer, and sweat gland cancer. Currently, the statistical classification reports do not include a concept for sweat gland cancer. |
Do Quyen
