Tumors: if the skin suffers, anti-cancer therapies

Tumors: if the skin suffers, anti-cancer therapies


Spots, dry skin, blisters, fissures: the tumor also leaves marks on the skin and, in most cases, the patient – focused on the goal of overcoming the disease – accepts the side effects of oncological therapies. Yet, dermatological problems (including those with brittle hair and nails) can have a far from negligible impact and not only on a psychological level, but which can also be reflected in how patients follow therapies.

Skin toxicities

“Anti-cancer treatments can lead to the onset of numerous skin toxicities, which are still often “orphaned” by dedicated studies and specialists”, he explains Paolo Ascierto, director of the Melanoma Oncology, Oncological Immunotherapy and Innovative Therapies Unit of the Pascale Foundation Tumor Institute of Naples, who specifies: “For example, in the case of drugs belonging to the target therapy category that we use in the treatment of melanoma, the toxicities The most frequent skin conditions of all are skin rash, acneiform dermatitis, erythema nodosum and panniculitis”. Many of these side effects also concern immunotherapy, considered the cutting edge of oncological treatments.

“Paradoxically – underlines the oncologist – in the patient treated with immunotherapy the appearance of some dermatological side effects, such as vitiligo for example, is correlated with a better response to therapy, because it is a clear signal of the fact that the system immunity has been activated.” Sometimes, however, these effects are more serious, as happens, for example, when Stevens-Johnson syndrome occurs, which causes exfoliation of the skin, as well as fever and generalized pain. “In these cases – continues Ascierto – immediate treatment with cortisone or immunosuppressants is necessary, because otherwise it could prove fatal”.

The side effects of oncological therapies

In most cases, however, the side effects are milder, but capable of impacting the patient’s quality of life, who at a delicate moment in his life must also face a series of unpleasant external changes such as hair loss, more brittle nails and even dry skin. And, especially when cancer affects younger people, these effects are anything but secondary.

“More than 80% of patients, in fact, have side effects on the skin and in some cases this percentage can reach almost 90% with the risk that someone interrupts or even abandons the therapy, thus compromising the effectiveness of the treatment,” he warns Pietro Sollenadermatologist at the “Agostino Gemelli” University Polyclinic Foundation in Rome and coordinator of the “TiCuro” task force of the Italian Society of Medical, Surgical, Aesthetic Dermatology and Sexually Transmitted Diseases (SIDeMaST).

What precautions to take

How to react, then, to these side effects? “First of all, patients need to be informed of the possible skin toxicities that may arise during treatment and should therefore be referred to a dermatologist who can suggest how to prevent them,” he replies. Davide Fattoredermatologist at the “Il corpo Trovato” clinic, dedicated to the prevention and treatment of skin toxicities that arise during oncotherapy and opened at the University of Naples Federico II.

“If the patient has to follow a therapy that can make the skin dry, it is immediately advisable to use products such as delicate detergents, soaps, shampoos and creams, all of which are non-aggressive. It is important to always hydrate the skin with a nourishing and chemical-free cream. perfume”. Particular caution should also be paid to scars that remain after surgery. Once the scar has healed completely, it is recommended to massage it gently every day and, possibly, with the help of a specific gel for at least a month, so as to help it develop a flatter appearance. It is also important not to expose the scar to the sun if it is not properly protected, not to rub it and always wear soft, loose-fitting clothing.

The multidisciplinary approach

“We must proactively address the needs of these patients. The treatment approach must necessarily change, because today the objective is no longer just to treat the disease, but to achieve the overall well-being of the person. Skin problems linked to oncology therapies can have an impact not only on the physical, but also on the psychological sphere, on social relationships, as a couple”, he underlines Giuseppe Argenziano, director of the Dermatology Clinic of the University of Campania “Luigi Vanvitelli” and president of SIDeMaST and of the “TiCuro” task force. “For this reason – he adds – it is essential to consider the patient in his complexity, through a multidisciplinary management that includes the dermatologist to provide adequate support at every stage: starting from the diagnosis up to the management of the skin during therapies” . The possibility of also having a dermatology service in the same center, with professionals with specific experience and skills in managing the skin problems of cancer patients, thus becomes fundamental: both for the development of the treatment plan and for the early identification of side effects induced by therapies.

The Skin & Cancer project

When will my hair start falling out? Can I expose myself to the sun while I am being treated with immunotherapy? Can I get a tattoo? These are some of the most frequent questions asked by cancer patients who today are increasingly able to live with the disease for a long time. The ‘Skin & Cancer’ project seeks to provide concrete help Pierre Fabre Italia (Eau Thermale Avène) created in collaboration with the SIDeMaST (Italian Society of Medical, Surgical, Aesthetic Dermatology and Sexually Transmitted Diseases) task force ‘Ticuro’ and with the main Italian patient associations (AIMa.Me., APaIM , Melanoma Italia Onlus Association, Europa Donna Italia, IncontraDonna Foundation). The objective of the initiative is to optimize the path of cancer patients with adverse skin reactions, to provide adequate support at every stage, from diagnosis to treatment management and follow-up. In addition to holding meetings for the training of medical specialists, a brochure in which the specialists of the SIDeMaST task force explain how patients can take care of their skin during the therapeutic process by answering very practical questions such as, for example, what to do if you notice changes on your skin, hair and nails; how to take care of your scar after surgery or even whether you can wear makeup or shave.



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