6 Ways Oncologists and Dermatologists Can Work Together to Improve Cancer Care

JULY 14, 2015
Beth McLellan, MD
4.  Recognize the importance of dermatologic toxicities on patients’ well-being
Often, the psychological impact of common and expected adverse events, such as alopecia, can be overlooked as providers focus on more life-threatening problems. Alopecia has become even more important to patients as better treatments have become available for other adverse events such as nausea. Although more research is needed to determine how to best prevent alopecia, patients often appreciate being told about things like minoxidil for the scalp and topical bimatoprost for the eyelashes, which can speed up hair growth. Adverse events that may have been minor in patients who were only receiving treatments for a short period of time become more important in patients who remain on medications long-term. For example, acneiform eruptions, paronychia, xerosis, and pruritus can be disabling in patients on EGFR inhibitors attempting to carry on their normal lives during cancer treatment.
5.  Include dermatologic evaluation in clinical trials
Dermatologists should be included in chemotherapy clinical trials, when possible, so potential dermatologic toxicities can be classified and studied earlier in the drug investigation. Often these toxicities are underreported or documented generically as “rash.” Potential prophylactic and therapeutic strategies for adverse events related to the skin, hair, and mucous membranes could be developed sooner – hopefully resulting in more patients remaining on an optimum dose of chemotherapy – if dermatologists were regularly part of clinical trials from the early phases.
6.  Incorporate dermatology care in survivorship plans
Dermatologic care is important for cancer survivors, especially those who have received radiation as part of their cancer therapy. Studies of survivors of childhood cancers have revealed a significantly increased risk of secondary skin cancers in radiated skin and routine dermatologic evaluation is currently recommended for survivors of childhood cancers. Annual full skin examination by a dermatologist should also be considered in survivorship plans for appropriate adult patients. 

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