Quality of Life in Patients with Surgically Removed Skin Tumors

Background and Objectives: Skin cancer is one of the most frequently diagnosed malignancies. The main goal of the therapeutic management is total excision with the prevention of recurrence and metastasis. The quality of life of the patients with skin cancer is affected by the morbidity risk, surgery, and cosmetic or functional aspects. The aim of this study was to evaluate the quality of life of patients with skin cancer prior to and post surgical intervention. Material and methods: We performed a prospective study on 247 patients with skin tumors. Quality of life was evaluated through an initial questionnaire that was given to all consenting patients. This was used to determine patients' mobility, selfcare, normal activities, pain, and despair, using a five-point Likert scale. The general autoperceived health state was also recorded using a 100-point scale. The study included the responses of all patients at hospital admission, after one month of surgery, and after one year of surgery. Results: In patients with squamous cell carcinoma (SCC), the general health state indicator statistically significantly decreased one month after surgery and increased at one-year follow-up. In malignant melanoma (MM) patients, mobility, selfcare, normal activities, and discomfort presented a decrease in values one year after surgery, compared to the values registered at hospital admission. In patients with basal cell carcinoma (BCC), all indicators of quality of life presented an impaired value one year after surgery, after a decreasing trend. The general health state indicator statistically significantly increased one month after surgery and after one year. Conclusions: Surgery is one of the main steps in treating skin cancer. It has a great impact on patients' quality of life because of pain andthe effect on mobility and normal activities. Skin cancers influence the quality of life of patients both psychologicallyand physically.

Influence of demographic and clinical characteristics of actinic keratosis patients on illness perceptions and readiness to increase sun protection behaviours: an exploratory study

BACKGROUND/PURPOSE

There are no data comprehensively investigating the key beliefs and sun protection behaviours in patients with actinic keratosis (AK). Our aim was to determine and correlate the AK perceptions and readiness to increase sun protection (RISP) behaviours.

METHODS

AK patients' (n = 200) demographics and clinical findings were recorded. Participants completed questionnaires (Illness Perception Questionnaire-Revised and RISP behaviours scales).

RESULTS

The mean scores of giving up sunbathing of the patients aged <65 years, and giving up sunbathing and staying in the shade behaviours of females were higher. As the level of education increased, while the mean scores of giving up sunbathing decreased, using sunscreen scores increased. The mean scores of giving up sunbathing, using sunscreen and wearing protective clothing of those with the history of non-skin cancer (had cancer other than of the skin) were lower. The readiness to increase using sunscreen was found to be higher in patients with more chronic timeline beliefs, more positive perceived personal control and blaming sunlight more, and the wearing protective clothing was found to be higher in those with more cyclical timeline beliefs.

CONCLUSION

AK patients, especially the subjects aged ≥65 years, have non-skin cancer history, and male gender should be informed to apply sun-protective behaviours.

Field Treatment of Actinic Keratosis With Ingenol Mebutate

There is a need for early, effective field treatments for actinic keratosis (AK) that target subclinical as well as clinically visible lesions to minimize the recurrence and emergence of new lesions. Ingenol mebutate gel is an effective and well-tolerated topical field therapy that has demonstrated sustained clearance and long-term reduction of AKs. This article reviews findings from the FIELD study program and highlights health-related quality of life (HRQoL) outcomes for patients receiving ingenol mebutate. Efficacy data from the FIELD study program are discussed and the tolerability profile of ingenol mebutate in the treatment of areas of up to 100 cm2 is considered. These findings are then placed in the context of HRQoL outcomes and their relevance for patients.<br /><br /> <em>J Drugs Dermatol</em>. 2016;15(5):535-542.

Differences in Disease-specific Quality of Life in Patients with Actinic Keratosis in Australia and Denmark

Actinic keratosis (AK) negatively influences patient quality of life as measured by the disease-specific Actinic Keratosis Quality of Life (AKQoL) questionnaire. The quality of life in Australian patients was significantly less affected than in Danish patients. We hypothesize that general factors such as public awareness and cultural connotations of AK, may influence the impact of AK on quality of life (QoL).

Physicians' concerns towards prescription adherence and treatment effectiveness in the clinical management of actinic keratosis

AIM

We report concerns toward prescription adherence and treatment effectiveness in the clinical management of actinic keratosis (AK) in Italy.

METHODS

We carried out a cross-sectional web-based survey among Italian dermatologists across Italy. Physicians were asked to answer a self-administered questionnaire about their concerns around AK therapy and barriers to patients' adherence. Each physician also profiled his last patient and answered items concerning his experience with topical treatments and the suitability of current and future treatment options for the profiled patient.

RESULTS

Fifty practitioners answered the survey. Most dermatologists agreed that field-therapy is a key element for the management of AK in most patients, and 76% (N.=38) agreed that topical treatments were the best option in such cases given their ability to target subclinical lesions. However most interviewee underlined the importance of fostering patients' adherence and minimizing side effects in order to maximize benefits from therapy.

CONCLUSION

We showed that features of current therapeutic options for field-directed therapy (namely long duration of treatment, intensity and duration of local skin reaction) raise practitioners' concerns toward patients' prescription adherence and real-world effectiveness.

Patients highly value routine follow-up of skin cancer and cutaneous melanoma

INTRODUCTION

Skin cancer follow-up is a substantial burden to outpatient clinics. Few studies have investigated patients' views on skin cancer follow-up and cutaneous melanoma. The objective was to investigate patients' perceived benefits and the impact of follow-up.

MATERIAL AND METHODS

This study included an open sample of patients attending routine follow-up at the outpatient Departments of Plastic Surgery and Dermatology, Roskilde Hospital. A total of 218 follow-up patients diagnosed with cutaneous malignant melanoma (MM), non-melanoma skin cancer (NMSC) or actinic keratosis (AK) completed a structured interview.

RESULTS

A total of 97% patients found follow-up useful. Continuity and consistency were important. One third of patients felt some degree of pre follow-up anxiety. The number of anxious MM patients was significantly greater than that of NMSC patients. No significant difference was found between the number of anxious MM and AK patients. Female gender, cohabitation and age younger than 50 years were associated with increased levels of anxiety. No relation was found between the number of anxious patients or the level of anxiety and the duration of the follow-up period.

CONCLUSION

The majority of patients who attended found that the follow-up had been useful. Certain demographic characteristics were associated with higher levels of anxiety and may be addressed by supportive efforts targeting these groups.

Clinical characteristics and awareness of skin cancer in Hispanic patients

Skin cancer in darker skin is associated with considerable morbidity and mortality. We sought to assess the clinical characteristics of cutaneous malignancy amongst Hispanic skin cancer patients and compare them to age-matched non-Hispanic Caucasians. In this retrospective study, 150 Hispanic skin cancer patients were identified from electronic medical records and age-matched to 150 non-Hispanic Caucasian controls with skin cancer. The incidence of actinic keratoses (AKs) in Hispanic skin cancer patients (34.0%) was statistically lower than age-matched non-Hispanic Caucasian skin cancer controls (61.3%, P <0.001; odds ratio, 3.08; 95% confidence interval, 1.92 - 4.93). Moreover, non-Hispanic Caucasian SCC (squamous cell cancer) controls were much more likely to report AKs (36.1%, P = 0.003) than Hispanic SCC patients (25.0%, P = 0.19). This study illustrates a lower incidence of AKs in Hispanic skin cancer patients as compared to their age-matched non-Hispanic Caucasians. The Hispanic skin malignancies present at a more advanced state and there is usually a lack of awareness in such cases. Therefore, patient knowledge and education is crucial for early detection and prevention of skin cancer in the Hispanic population.