Skin care management in cancer patients: an evaluation of quality of life and tolerability
Chicago, IL (Northwestern University - Original Article) –March 25th, 2010
Ann Cameron Haley, Cara Calahan, Mona Gandhi, Dennis P. West, Alfred Rademaker and Mario E. Lacouture
Thursday, March 25th, 2010
Skin care in cancer patients is suboptimal in part due to a lack of products and knowledge specific for this population. Our findings suggest that QoL improves with test article use, all of which were rated as good/very good for tolerability. Moreover, skin toxicity as manifested by dry skin, hand-foot skin reaction, and skin rash (dermatitis) were decreased with use of test articles within 4 weeks.
Discussion
Dermatologic toxicities are common side effects associated with anticancer treatments, and these adverse events often negatively impact a patient’s quality of life and willingness to continue with treatment [3]. Management of these events in cancer patients is suboptimal in part due to the lack of products specifically designed for this patient population. In seeking to investigate the tolerability and effects on quality of life for products designed for cancer skin care management, these findings suggest that quality of life, as measured by Skindex-16, improves with products specifically designed for cancer skin care management. Moreover, the severity of skin toxicity graded according to CTCAE decreases within 1-month use of products specifically designed for cancer skin care management, and dermatology quality of life significantly improves as early as 1 month for individual domains (symptoms, emotions, functions).
This study demonstrates that products specifically designed for cancer skin care management improve skin-related quality of life. Moreover, patients with rosacea and rosacea-like erythematous facial skin are often very sensitive to skin care products that can worsen inflammation and produce irritation [16]. This study demonstrated cancer patients with pre-existing rosacea tolerate test articles A, B, and C. Maintenance of cutaneous integrity during cancer treatments with the use of moisturizers may aid in mitigating dry skin, which may be associated with pruritus and infections, minimizing these comorbidities [17, 18].
In summary, specifically tailored skin care management for cancer patients is well tolerated by patients currently undergoing anticancer therapy or radiation, and a majority of subjects report that such therapies are better than previous regimens used. A majority of participants also report improved dermatology QoL. Previous studies indicate that dermatology QoL rebounds within 4 months of completion of anticancer regiments, making it important for patients to receive interventions during anticancer therapy and the immediate 4-month follow-up period [19].
Advance knowledge of side effects and proactive management approaches have been shown to decrease anxiety, improve adherence to cancer treatment, and improve QoL and patient outcomes [5]. Studies suggest that anticancer therapy side effects are less anxiety provoking when anticipated [20]. If patients engage in anticipatory coping, a mechanism involving “affective and behavioral rehearsal,” patients feel in control when toxicities resulting from cancer treatments arise [21]. A cancer skin care management program fulfills patient engagement of anticipatory coping in order to optimally anticipate and control cutaneous side effects associated with anticancer therapy.
Acknowledgments We are grateful to Lindi®Skin for providing test articles. M.E.L. is supported by a Zell Scholarship from the Robert H Lurie Comprehensive Cancer Center and a Dermatology Foundation Career Development Award.
