New Subspecialty Improves Quality of Life for Patients With Cancer

 

The Dermatologist spoke with Adam Friedman, MD, FAAD, professor of dermatology at George Washington School of Medicine and Health Science and director of the supportive oncodermatology clinic, about supportive oncodermatology and its role in cancer treatment.  

Dr Friedman

Since the development of targeted biologics and small molecule inhibitors, patients with certain cancers are living longer. However, some of the treatments that extend patients’ lives are also associated with dermatologic adverse effects that can reduce their quality of life and limit treatment duration and efficacy, or even lead to treatment cessation. 

To address the needs of this patient population, Adam Friedman, MD, FAAD, associate professor of dermatology at George Washington (GW) School of Medicine and Health Science, partnered with the GW Cancer Center to open an oncodermatology clinic. Dr Friedman is the director of the clinic, which he said addresses 2 important needs.

“The clinic serves as a resource for the GW Cancer Center to utilize when the expected hair, skin, and nail adverse events occur in their exponentially growing patient population in order to minimize the associated morbidity of their therapies,” he said. “Also, it is a much-needed training opportunity for residents who will no doubt encounter these and many more dermatologic issues relating to cancer interventions.”

Supportive Oncodermatology

According to Dr Friedman, supportive oncodermatology is an emerging subspecialty between oncology and dermatology that seeks to address the dermatologic adverse events associated with cancer therapies, as well as provide necessary monitoring of patients to ensure the best potential survivorship.

“My goals are to provide the highest level of care to enable a patient to kick cancer’s ass without any handicap and to prepare future dermatologists for this exponentially increasing patient population with unique care needs,” he said. “I think a supportive oncodermatology program is a wonderful way to bridge the divide between oncology and dermatology.” 

Preventive Strategies to Reduce Dermatologic Adverse Effects 

There are several options for preventing and treating dermatologic adverse effects associated with cancer treatments. “In general, proper skin care is a must,” said Dr Friedman. “This includes mild soap use, moisturizers to wet skin, and proper use of sun protective measures that includes both sunscreen and protective clothing.” 

For reactions to certain treatments, Dr Friedman suggested some options that have shown success both in the literature and anecdotally. Prophylactic sun protection, moisturizer, twice-daily 100 mg doxycycline, and hydrocortisone 2.5% cream have been shown to prevent papulopustular eruptions without sacrificing efficacy among patients receiving epidermal growth factor receptor inhibitors and human epidermal growth factor receptor 2 inhibitors, he said. Isotretinoin is another viable option when doxycycline fails, he added. For patients receiving tyrosine kinase inhibitors, there is evidence that urea 40% cream can prevent, as well as manage, hand and foot syndrome. Cooling gloves and DigniCap have been shown to prevent taxane associated onycholysis and alopecia, respectively. 

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