Skin care management in cancer patients: an evaluation of quality of life and tolerability

Ann Cameron Haley, Cara Calahan, Mona Gandhi, Dennis P West, Alfred Rademaker, Mario E Lacouture, Ann Cameron Haley, Cara Calahan, Mona Gandhi, Dennis P West, Alfred Rademaker, Mario E Lacouture

Abstract

Purpose: The objective of this study is to evaluate quality of life (QoL) and tolerability of three articles specifically developed for cancer skin care management (skin moisturizer, face moisturizer, and face wash).

Methods: Participants were cancer patients (n = 99) receiving systemic anticancer therapies and/or radiotherapy at Northwestern University. Subjects were assessed at the initial visit for adverse skin reactions based on the National Cancer Institute's Common Terminology Criteria for Adverse Events version 3.0 and completed the Skindex-16 questionnaire, a self-reported dermatology-specific QoL instrument. All subjects were provided with three test articles and were instructed to use each test article once daily for 4 weeks. At the 4-week follow-up (n = 77), the Skindex-16 was readministered, adverse skin reactions were assessed, and tolerability questionnaires were administered for each article used.

Results: Dry skin, hand-foot skin reaction (HFSR), and skin rash (dermatitis) decreased significantly from baseline to follow-up. Presence of nail changes, skin rash (desquamation), and acne/acneiform eruptions did not significantly change from baseline. Subjects had a significantly lower mean overall Skindex-16 score at 4-week follow-up when compared to baseline. Most patients rated their overall experience with each test article as good or very good (highest rating).

Conclusion: 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.

Figures

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Skin care management tolerability questionnaire
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Skin care management tolerability questionnaire
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Skin care management tolerability questionnaire
Fig. 1
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Skin care management tolerability questionnaire
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Skin care management tolerability questionnaire
Fig. 2
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Change in Skindex-16 scores from baseline to 4-week follow-up

References

    1. Lacouture M, West D, Tigue C, Knox K, Bennett C. Cutaneous toxicities of targeted cancer therapies. Community Oncology. 2008;5(7):413–414.
    1. Hackbarth M, Haas N, Fotopoulou C, Lichtenegger W, Sehouli J. Chemotherapy-induced dermatological toxicity: frequencies and impact on quality of life in women's cancers. Results of a prospective study. Support Care Cancer. 2008;16(3):267–273. doi: 10.1007/s00520-007-0318-8.
    1. O'Keeffe P, Parrilli M, Lacouture M. Toxicity of targeted therapy: focus on rash and other dermatologic side effects. Oncol Nurses Ed. 2006;20:1–6.
    1. Wagner L, Lacouture M. Dermatologic toxicities associated with EGFR inhibitors: the clinical psychologist's perspective. Impact on health-related quality of life and implications for clinical management of psychological sequelae. Oncology (Williston Park) 2007;21(11 Suppl 5):34–36.
    1. Gandhi M, Oishi K, Zubal B. Unanticipated toxicities from anti-cancer therapies: survivors’ perspectives.Support Care in Cancer (in press)
    1. Autier J, Escudier B, Wechsler J, Spatz A, Robert C. Prospective study of the cutaneous adverse effects of sorafenib, a novel multikinase inhibitor. Arch Dermatol. 2008;144(7):886–892. doi: 10.1001/archderm.144.7.886.
    1. Richardson L, Wang W, Hartzema A, Wagner S. The role of health-related quality of life in early discontinuation of chemotherapy for breast cancer. Breast J. 2007;13(6):581–587. doi: 10.1111/j.1524-4741.2007.00512.x.
    1. Susser W, Whitaker-Worth D, Grant-Kels J. Mucocutaneous reactions to chemotherapy. J Am Acad Dermatol. 1999;40(3):367–398. doi: 10.1016/S0190-9622(99)70488-3.
    1. Lynch T, Kim E, Eaby B, Garey J, West D, Lacouture M. Epidermal growth factor receptor inhibitor-associated cutaneous toxicities: an evolving paradigm in clinical management. Oncologist. 2007;12(5):610–621. doi: 10.1634/theoncologist.12-5-610.
    1. McQuestion M. Evidence-based skin care management in radiation therapy. Semin Oncol Nurs. 2006;22(3):163–173. doi: 10.1016/j.soncn.2006.04.004.
    1. Bolderston A, Lloyd N, Wong R, Holden L, Robb-Blenderman L. The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer. 2006;14(8):802–817. doi: 10.1007/s00520-006-0063-4.
    1. Lindi®Skin (2008)
    1. CTC v2.0 and common terminology criteria for adverse events v3.0 (CTCAE). (2009)
    1. Chren M, Lasek R, Sahay A, Sand L. Measurement properties of Skindex-16: a brief quality-of-life measure for patients with skin diseases. J Cutan Med Surg. 2001;5(2):105–110. doi: 10.1007/BF02737863.
    1. Basch E, Iasonos A, McDonough T, Barz A, Culkin A, Kris M, et al. Patient versus clinician symptom reporting using the National Cancer Institute Common Terminology Criteria for Adverse Events: results of a questionnaire-based study. Lancet Oncol. 2006;7(11):903–909. doi: 10.1016/S1470-2045(06)70910-X.
    1. Weber T, Ceilley R, Buerger A, Kolbe L, Trookman N, Rizer R, et al. Skin tolerance, efficacy, and quality of life of patients with red facial skin using a skin care regimen containing Licochalcone A. J Cosmet Dermatol. 2006;5(3):227–232. doi: 10.1111/j.1473-2165.2006.00261.x.
    1. Robert C, Soria JC, Spatz A, Le Cesne A, Malka D, Pautier P, et al. Cutaneous side-effects of kinase inhibitors and blocking antibodies. Lancet Oncol. 2005;6(7):491–500. doi: 10.1016/S1470-2045(05)70243-6.
    1. Eilers RE, Jr, Gandhi M, Patel JD, Mulcahy MF, Agulnik M, Hensing T, et al. Dermatologic infections in cancer patients treated with epidermal growth factor receptor inhibitor therapy. J Natl Cancer Inst. 2010;102(1):47–53. doi: 10.1093/jnci/djp439.
    1. Fairclough D, Fetting J, Cella D, Wonson W, Moinpour C. Quality of life and quality adjusted survival for breast cancer patients receiving adjuvant therapy. Eastern Cooperative Oncology Group (ECOG) Qual Life Res. 1999;8(8):723–731. doi: 10.1023/A:1008806828316.
    1. Frith H, Harcourt D, Fussell A. Anticipating an altered appearance: women undergoing chemotherapy treatment for breast cancer. Eur J Oncol Nurs. 2007;11(5):385–391. doi: 10.1016/j.ejon.2007.03.002.
    1. Burish T, Snyder S, Jenkins R. Preparing patients for cancer chemotherapy: effect of coping preparation and relaxation interventions. J Consult Clin Psychol. 1991;59(4):518–525. doi: 10.1037/0022-006X.59.4.518.

Source: PubMed

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