Targeted Therapy-induced Facial Skin Toxicities: Impact on Quality of Life in Cancer Patients

Abstract

Objective:Targeted therapy-induced facial skin toxicities may reduce overall quality of life (QoL) in cancer patients. We investigated whether facial skin toxicities affect QoL and attempted to identify factors related to QoL in patients with advanced/recurrent cancer.Methods:We performed a cross-sectional study in 34 outpatients with advanced/recurrent cancer showing targeted therapy-induced facial skin toxicities in Japan between November 2016 and February 2017. For measurement, we used the Kessler Psychological Distress Scale (K6), Mental Adjustment to Cancer (MAC) Scale, and Dermatology Life Quality Index (DLQI). Data were analyzed using Spearman's rank correlation coefficient.Results:Mean DLQI score in 34 patients was 4.59 (standard deviation ± 4.70), which was interpreted as a small effect on a patient's life. Acneiform rash was the most common skin condition noted, followed by xerosis, pruritus, and erythema. Analysis of DLQI scores revealed that symptoms and feelings was the domain most commonly affected among different domains constituting the DLQI. MAC analysis revealed that the fighting spirit score was the highest among MAC scales. We found that age, K6, and fatalism construct in MAC were significantly correlated with total DLQI scores (age: Spearman's ρ= −0.48, P = 0.004; K6: ρ= 0.58, P < 0.001; fatalism; ρ= −0.39, P = 0.025).Conclusions:This is the first study investigating targeted therapy-induced facial skin toxicities in cancer patients. Our results suggest potential negative effects of facial skin toxicities on overall QoL in patients with advanced/recurrent cancer in middle and early old age.

Analysis of Influence Factors of Quality of Life of Lung Cancer Patients with Skin Adverse Drug Reactions Under Targeted Therapy

“…The pruritus, irritation, sensitivity of skin often made patients upset which could disrupt the sleep cycle and daily activities [31]. Moreover, the xerosis, thinning, shriveling, darkening of skin can increase pressure in social life and lead to social participation barriers [32], these issues could be further enhanced by anxiety, depression, emotional instability and inferiority caused by the persistent helplessness to ADRs [33].…”

“…For example, the symptoms such as itchiness caused by severe skin ADRs can disturb sleep, and symptoms occurred on hands and feet negatively affected daily activities of patients [13]. Meanwhile, as skin condition plays an important role in body image and self-esteem, long-term and severe skin ADRs also affect the intimate and interpersonal relationships of patients [14], and result in increased psychological issues such as anxiety, and lead to social participation disorders [15]. Therefore, skin toxicities can have a profound impact on patients' quality of life (QoL) owing to symptoms caused and potential esthetic sequelae.…”

US Cutaneous Oncodermatology Management (USCOM): A Practical Algorithm

“…Many studies are available on cAEs; however, more robust studies are needed on prevention, treatment, and maintenance using skincare. [5][6][7][8][9][10][11][12][17][18][19][20]22,25,29,39 cAEs negatively affect functional and emotional domains relating to QoL in cancer patients. Moreover, multiple negative experiences due to cAEs may increase psychological distress and avoidance of personal relationships, leading to social isolation.…”

“…Moreover, multiple negative experiences due to cAEs may increase psychological distress and avoidance of personal relationships, leading to social isolation. [6][7][8]39 Patients reported that cAEs significantly limit their daily activities and are an essential contributor to a reduced QoL. [6][7][8]39 Women noted alopecia as the most traumatic adverse event of various systemic cancer treatments.…”

“…[6][7][8]39 Patients reported that cAEs significantly limit their daily activities and are an essential contributor to a reduced QoL. [6][7][8]39 Women noted alopecia as the most traumatic adverse event of various systemic cancer treatments. 18,23,24,40 Although clinicians acknowledged the importance of achieving a sufficient balance between cancer-treatment efficacy and cAEs to maintain an optimal QoL in cancer survivors, the research available on the prevention and treatment using an effective skincare regimen for these cAEs is limited.…”