Treating skin-related side effects of cancer treatments

Overall, cancer deaths in the U.S. have gone down for the past two decades, thanks in part to immunotherapy and specialized therapies.

But those life-saving treatments sometimes come with a cost.

At 78, George Handy still does the landscaping at his suburban D.C. home.

Yardwork and 25 years in the Army meant he was outdoors in the sun, for hours on end.

"I'm fair-skinned. I grew up in a time when nobody really worried about skin damage," he admits.

But in July of 2018, unusual changes to his scalp took a life-threatening turn.

"It started as skin cancer and ended up as neck cancer," George explains.

George had surgery, six chemo treatments and six full weeks of radiation. The treatments knocked cancer into remission, but then he developed two horrible rashes. One was diagnosed as radiation dermatitis.

"Looks like acne, but it is utterly miserable," says dermatologist Adam Friedman, MD, of GW Cancer Center.

Friedman is one of a handful of U.S. experts practicing supportive oncodermatology, which is the treatment of skin-related side effects of cancer treatments.

"Very often doctors will stop or lower treatment courses because of these skin side effects, so if I can prevent that and get a patient through their course to treat -- and possibly cure -- their cancer, that is of utmost importance," Friedman says.

In George's case, Friedman prescribed a medication and topical cream for the rash.

It's letting him spend more quality time with his wife, Marilyn, and the people he loves most.

The doctor says some of the other common side effects include infections, severely dry and itchy skin, brittle or lost nails, and changes to hair.

In addition to GW Cancer Center, there are about 10 other major medical centers offering supportive oncodermatology.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC: TREATING NASTY CANCER SIDE EFFECTS
REPORT: MB #4653

BACKGROUND: Sometimes radiation therapy can cause the skin on the part of your body receiving radiation to become dry and peel, itch, and turn red or darker. Your skin may look sunburned or become swollen or puffy. You may develop sores that become painful, wet, and infected. This is called a moist reaction. You may also develop a minor rash or sunburn easily; this is called photosensitivity. Some people also have skin pigmentation changes. Your nails may be dark and cracked, and your cuticles may hurt. If you received radiation therapy in the past, the area of skin where you received radiation may become red, blister, peel, or hurt. This is called radiation recall. Signs of an allergic response to chemotherapy may include a sudden or severe rash or hives or a burning sensation. (Source: https://www.cancer.gov/about-cancer/treatment/side-effects/skin-nail-changes)

ONCODERMATOLOGY: The word oncodermatology itself offers some explanation of the word's meaning. "Onco" means relating to tumors, and it is typically used in the medical field as part of words describing cancer treatments. Dermatology is the field of medicine that provides treatment for diseases and conditions that affect the skin. Oncodermatology refers to the diagnosis, treatment, and management of skin conditions that develop in relation to cancer treatments. There is a need for dermatologists who specialize in caring for cancer patients, and recently centers around the country have slowly been taking notice. (Source: https://www.usdermatologypartners.com/blog/what-is-oncodermatology-everything-you-need-to-know/)

NEW RESEARCH: Adam Friedman, MD, Director of Supportive Oncodermatology, Professor and Interim Chair of Dermatology at the GW Cancer Center talked about the mission of oncodermatology, "First and foremost, it's to try to prevent some of these kind of reactions which there is evidence that we can do that if we see patients before they start their therapy. But more often than not, it's treating it once it happens. Being an academic center, there is ease of communication between the cancer center and dermatology, so we can get these patients in pretty quickly. We have a dedicated clinic to seeing these patients. And so my goal is to lessen the burden." Dr. Friedman says the clinic has been open for about two years at the GW Cancer Center.

(Source: Adam Friedman, MD)