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Dreno B, Khosrotehrani K, De Barros Silva G, Wolf JR, Kerob D, Trombetta M, Atenguena E, Dielenseger P, Pan M, Scotte F, Krakowski I, Lacouture M. The role of dermocosmetics in the management of cancer-related skin toxicities: international expert consensus. Support Care Cancer 2023; 31:672. [PMID: 37925388 PMCID: PMC10625513 DOI: 10.1007/s00520-023-08116-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/11/2023] [Indexed: 11/06/2023]
Abstract
Skin toxicities are very common in patients undergoing cancer treatment and have been found to occur with all types of cancer therapeutic interventions (cytotoxic chemotherapy, targeted therapies, immunotherapy, and radiotherapy). Further, skin toxicities can lead to interruption or even discontinuation of anticancer treatment in some patients, translating to suboptimal outcomes. Dermocosmetics (or cosmeceuticals)-defined as skincare solutions incorporating dermatologically active ingredients (beyond vehicle effects) that directly improve symptoms of various skin conditions-are increasingly being used in cancer care to prevent and manage skin toxicities. The active ingredients in these products have a measurable biological action in skin; they typically improve skin integrity (barrier function/hydration and other factors) while relieving skin symptoms. The Association Francophone des Soins Oncologiques de Support (AFSOS) and Multinational Association of Supportive Care in Cancer (MASCC) partnered to select a multidisciplinary group of healthcare professionals involved in the management of patients with cancer and skin toxicities. The group reviewed existing literature and created a summary of recommendations for managing these toxicities through online meetings and communication. In this publication, the group (1) reviews new skin toxicities seen with oncology drugs and (2) evaluates the role of dermocosmetics in improving patient outcomes and minimizing cancer treatment interruptions. We provide general recommendations for initiation and selection of skin care in all oncology patients as well as recommendations for what factors should be considered when using dermocosmetics in specific types of skin toxicities.
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Affiliation(s)
- Brigitte Dreno
- Nantes Université, INSERM, CNRS, Immunology and New Concepts in Immunotherapy, INCIT, UMR 1302/EMR6001. F-44000, Nantes, France
| | - Kiarash Khosrotehrani
- Experimental Dermatology Group, University of Queensland Diamantina Institute, Brisbane, Australia
| | | | - Julie Ryan Wolf
- Departments of Dermatology and Radiation Oncology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Mark Trombetta
- Department of the Radiologic Sciences, Allegheny Health Network, Drexel University College of Medicine, Pittsburgh, PA, USA
| | - Etienne Atenguena
- Department of Internal Medicine, University of Yaoundé I, Yaoundé Hospital General, Yaoundé, Cameroon
| | - Pascale Dielenseger
- Research and Education for Paramedic Professionals Nursing Coordinator, Gustave Roussy, Villejuif, France
- École Des Sciences du Cancer, Université Paris Sud (XI), Paris, France
- Association Française Des Infirmières de Cancerologie (AFIC), Paris, France
| | - Meng Pan
- Department of Dermatology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Florian Scotte
- Interdisciplinary Patient Pathway Division, Gustave Roussy, Villejuif, France
- Multinational Association of Supportive Care in Cancer (MASCC), Aurora, Canada
| | - Ivan Krakowski
- Medical Oncologist, Bordeaux, France
- Association Francophone Des Soins Oncologiques de Support (AFSOS), Bègles, France
| | - Mario Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Lee J, Lim J, Park JS, Kim M, Kim TY, Kim TM, Lee KH, Keam B, Han SW, Mun JH, Cho KH, Jo SJ. The Impact of Skin Problems on the Quality of Life in Patients Treated with Anticancer Agents: A Cross-Sectional Study. Cancer Res Treat 2017; 50:1186-1193. [PMID: 29237254 PMCID: PMC6192901 DOI: 10.4143/crt.2017.435] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/12/2017] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Patients treated with anticancer agents often experience a variety of treatment-related skin problems, which can impair their quality of life. Materials and Methods In this cross-sectional study, Dermatology Life Quality Index (DLQI) and clinical information were evaluated in patients under active anticancer treatment using a questionnaire survey and their medical records review. RESULTS Of 375 evaluated subjects with anticancer therapy, 136 (36.27%) and 114 (30.40%) were treated for breast cancer and colorectal cancer, respectively. We found that women, breast cancer, targeted agent use, and longer duration of anticancer therapy were associated with higher dermatology-specific quality of life distraction. In addition, itching, dry skin, easy bruising, pigmentation, papulopustules on face, periungual inflammation, nail changes, and palmoplantar lesions were associated with significantly higher DLQI scores. Periungual inflammation and palmoplantar lesions scored the highest DLQI. CONCLUSION We believe our findings can be helpful to clinicians in counseling and managing the patients undergoing anticancer therapy.
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Affiliation(s)
- Jaewon Lee
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea.,Center for Skin Cancer and Adverse Skin Reaction to Chemotherapeutics, Seoul National University Cancer Hospital, Seoul, Korea
| | - Jin Lim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jong Seo Park
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea.,Center for Skin Cancer and Adverse Skin Reaction to Chemotherapeutics, Seoul National University Cancer Hospital, Seoul, Korea
| | - Miso Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sae-Won Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea.,Center for Skin Cancer and Adverse Skin Reaction to Chemotherapeutics, Seoul National University Cancer Hospital, Seoul, Korea
| | - Kwang Hyun Cho
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea.,Center for Skin Cancer and Adverse Skin Reaction to Chemotherapeutics, Seoul National University Cancer Hospital, Seoul, Korea
| | - Seong Jin Jo
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea.,Center for Skin Cancer and Adverse Skin Reaction to Chemotherapeutics, Seoul National University Cancer Hospital, Seoul, Korea
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Colloidal oatmeal emollient as an alternative skincare approach in radiotherapy: a feasibility study. JOURNAL OF RADIOTHERAPY IN PRACTICE 2016. [DOI: 10.1017/s1460396916000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAimTo assess the feasibility of a randomised controlled trial (RCT) on patients receiving radical radiotherapy for carcinoma of the anus in order to compare the present skincare advice at the time of the study with an alternative product, Aveeno, used primarily for dermatological and chemotherapeutic-induced skin conditions.Materials and methodStandardised Radiation Therapy Oncology Group (RTOG) grading and skincare assessments were used primarily to inform on physical reactions within a RCT. A pre-existing morbidity/quality-of-life instrument ‘the Head and Neck Radiotherapy Questionnaire’, which was validated for use with radiotherapy patients in preceding studies, was adapted for anus patients and formed the secondary basis for data collection. In all, 24 participants undergoing radical radiotherapy for anal cancer were randomised into two arms, Aveeno cream versus Aqueous Cream BP, and reviewed weekly to collect data and perform analysis and Mann–Whitney U non-parametric statistical tests.ResultsRTOG gradings for skin reactions were comparable week by week across the cohorts, with a baseline 100% of participants exhibiting RTOG 0 at week 1 in all areas, through to week 6 where both cohorts had progressed to higher RTOG grades. The Aveeno cohort, however, indicated ap-value approaching significance in regards to epidermal regeneration at follow-up 1 (p=0·0543). Questionnaires yielded diminishing responses as treatment progressed correlating with advancing RTOG grades, and exhibited increasing negativity in responses in correlation with advancing RTOG grade exhibited.ConclusionThe study was the first to recognise colloidal oatmeal as a skincare approach in the radiotherapy setting and recognises the potential benefits of Aveeno in radiation-induced skin reactions. The study determined the RTOG grading system to be robust as a method of evaluation of skin reactions and the questionnaires deemed the quality-of-life assessment to be a necessity in order to address patients’ psychological needs in addition to the physical needs.
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Achell Nava L, Hierro Orozco S, Maya Talamantes EI. Manejo y prevención de efectos secundarios al empleo de un anticuerpo monoclonal inhibidor de la señal de los receptores del factor de crecimiento epidérmico. GACETA MEXICANA DE ONCOLOGÍA 2016. [DOI: 10.1016/j.gamo.2015.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Lee JY, Jung D, Kim WH, Lee HJ, Noh DY, Hahm BJ. Correlates of oncologist-issued referrals for psycho-oncology services: what we learned from the electronic voluntary screening and referral system for depression (eVSRS-D). Psychooncology 2015; 25:170-8. [PMID: 26087369 DOI: 10.1002/pon.3879] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Depression in cancer patients is under-recognized and under-treated. To better identify depression, we designed a voluntary depression screening system. Based on its data, we examined trends in oncologist-issued referrals for the psycho-oncology service (POS). METHODS The Electronic Voluntary Screening and Referral System for Depression (eVSRS-D) comprises self-screening, automated reporting, and referral guidance. Using touch-screen kiosks at a tertiary hospital in Korea, participants with cancer completed the Patient Health Questionnaire-9 at their convenience, received the results, and reported their willingness to participate in POS. At oncology appointments, oncologists received the screening reports and issued referrals following pre-recommended guidelines. The correlates of actual referrals were examined across all participants and within the willing and non-willing groups. RESULTS Among the 838 participants, 56.3% reported severe depression symptoms, 30.5% wanted a referral, and 14.8% were actually referred. The correlates of participants' desire for referral were more severe depression symptoms, being unmarried, and being metastasis and recurrence free. Among all participants, the correlates of actual referrals were unemployment, less severe depression symptoms, poorer performance, treatment status, and wanting a referral. The sole correlate of actual referrals within the non-willing group was poorer performance, and no significant correlates existed within the willing group. The non-referrals were mostly (87.1%) because of postponed decisions. CONCLUSIONS The eVSRS-D cannot definitively diagnose major depression but may efficiently self-select a population with significant depression symptoms. The patients' willingness to engage the POS most strongly predicted the actual referrals. Oncologist reviews of screening reports may not result in further depression severity-specific referrals.
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Affiliation(s)
- Joo-Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dooyoung Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Won-Hyoung Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyuk-Joon Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong-Young Noh
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.,Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
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Macdonald JB, Macdonald B, Golitz LE, LoRusso P, Sekulic A. Cutaneous adverse effects of targeted therapies: Part I: Inhibitors of the cellular membrane. J Am Acad Dermatol 2015; 72:203-18; quiz 219-20. [PMID: 25592338 DOI: 10.1016/j.jaad.2014.07.032] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/22/2014] [Accepted: 07/22/2014] [Indexed: 12/18/2022]
Abstract
There has been a rapid emergence of numerous targeted agents in the oncology community in the last decade. This exciting paradigm shift in drug development lends promise for the future of individualized medicine. Given the pace of development and clinical deployment of targeted agents with novel mechanisms of action, dermatology providers may not be familiar with the full spectrum of associated skin-related toxicities. Cutaneous adverse effects are among the most frequently observed toxicities with many targeted agents, and their intensity can be dose-limiting or lead to therapy discontinuation. In light of the often life-saving nature of emerging oncotherapeutics, it is critical that dermatologists both understand the mechanisms and recognize clinical signs and symptoms of such toxicities in order to provide effective clinical management. Part I of this continuing medical education article will review in detail the potential skin-related adverse sequelae, the frequency of occurrence, and the implications associated with on- and off-target cutaneous toxicities of inhibitors acting at the cell membrane level, chiefly inhibitors of epidermal growth factor receptor, KIT, and BCR-ABL, angiogenesis, and multikinase inhibitors.
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Affiliation(s)
- James B Macdonald
- Department of Dermatology, Central Utah Clinic, Provo, Utah; Department of Pathology, Central Utah Clinic, Provo, Utah.
| | | | - Loren E Golitz
- Department of Dermatology, University of Colorado-Denver, Aurora, Colorado; Department of Pathology, University of Colorado-Denver, Aurora, Colorado
| | - Patricia LoRusso
- Department of Oncology, Wayne State University, Detroit, Michigan
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