CUTANEOUS CHEMOTHERAPY TOXICITY

T: It’s your first internship in cancerology, am I right?

N: Indeed. And I’m keen to be on duty.

T: Ok, let’s begin by checking some basic theoretical knowledge about cutaneous chemotherapy toxicity. Do happen to know anything about that?

N: I did some research on the subject, in order to be on the page.

T: Great. So, can you tell me what you have learned yet?

N: Sure. It’s that chemotherapy can have some repercussions on skin and its appendages, including hair, fingernails and other body parts. These symptoms should be detected and treated as early as possible, either by aesthetic or medical care, or both, so that the patient can comply with the treatment.

T: By the way, we’ll exclude transcutaneous or mucosal toxicity today, and we’ll just be dealing with dermatological toxicity and how it affects the patient’s quality of life.

N: All right. And I think we should be aware that the socioesthetic component can induce important psychological impacts, which is why communication and trust-relationship with the patient are key factors in holistic care.

T: Exactly. But, for now, what about the medical aspect?

N: Well, I guess we’d recommend the use of topical corticoids if symptoms are not serious, depending all the same on the body surface area and the pain level that should be assessed on the visual analogue scale. But also, we’d advise antibiotics in some cases.

T: And why do you think that the aesthetic aspect is as important as medical treatment?

N: We have to take into account not only the patients’ medical condition, but also, their psychological state, social, financial and family environments, and maybe also mostly their return to work, which is why physical appearance is also preponderant.

T: Your quite right, as hair loss, erythroderma, pruritis, hyperpigmentation, desquamation and dryness of skin, and also hyperkeratosis, and other side effects, might make people repulsive, which would have a serious influen ce on the patient’s body and self-images.

N: Not to mention the instrumental and elementary activities of daily living that might be affected. I mean, for instance, going for grocery shopping, preparing one’s meals, using the phone, putting on and taking off clothing, having a shower or bath, and what not, which one of my occupational therapy friends told me about. This is why, by the way, occupational therapists educate some cancer patients on how to make their own adapted clothes and how to use transfer boards in and out of the bathroom, among other activities of daily life.

T: And what about body hygiene measures?

N: I read that if roughness of the skin and fissures around the lips, nails, articulations, phalanges and heels appear, emollient lotions with milk ingredients should be used, and when bathing, to use warm water, thus avoiding hot showers and baths. Also, cotton wear is recommen ded. And when going out, sun protection products are needed.

T: I’m glad to see that you’re much informed on the subject, and believe that your internship will go fine and smoothly