Cancer treatment—including and especially melanoma—unfortunately, produces a risk of side effects impacting the feeling and vitality of the skin. Changes in the skin’s appearance may cause affected patients to experience severe distress and quality of life issues.

For some, skin concerns could accompany a desire to discontinue their treatment.

A potential solution has emerged for the 75% of patients with cancer who experience dermatologic side effects.1 A new dermatology specialty – oncodermatology – supports patients with cancer who develop unique skin concerns. The specialty is sometimes abbreviated as “SOD” to emphasize the Supportive role of the OncoDermatologists.2

The goal of oncodermatologists is to manage skin issues, allowing patients with cancer to continue treatment without interruption, dose modification, or discontinuation. Oncodermatologists recognize they are not treating the tumor. Instead, by treating the individual’s skin, they are optimizing cancer treatment outcomes and quality-of-life preservation.3

Treatment discontinuation and dose reduction due to skin concerns became a subject after the first targeted therapies to treat colorectal cancer were approved in 2009. A hallmark side effect of the drugs was a severe, acne-like rash covering the face and chest.4 Some patients’ feelings about their facial appearance caused avoidance of social activities and public-facing errands.

Since then, unwanted dermatologic drug side effects have grown into a massive clinical issue. Between 2013 and 2022, there were over three million reports about undesirable drug side effects to the FDA. Included in this data were 10,698 reports of cancer drugs with skin concerns, especially frequent rash and dry skin.1 Immunotherapies and targeted therapies are two of the main causes of dermatologic side effects, and melanoma is treated primarily with immunotherapies and targeted therapies. Oncodermatologists can be especially helpful to patients with melanoma who are undergoing treatment.

Radiation therapy can also negatively affect skin. For patients who receive radiation therapy, 95% will be affected by acute radiation dermatitis, which causes blistering, peeling, reddening, and pain.5 Oncodermatologists may consult with patients about hygiene, moisturization, sun protection, topical aqueous creams, topical corticosteroids, dressings, and camouflage products.5,6

Thus far, supportive oncodermatology has decreased therapy discontinuation and improved outcomes in cancer centers. Studies show that many practices with supportive oncodermatologists provided an appointment for consultation within the same day or the next day the patient reported symptoms.2 One institution showed that less than 15% of cases were recommended for drug discontinuation after consultation and treatment by oncodermatology.7 By allowing these patients to remain on therapy, their risk for cancer progression was diminished.

If you are experiencing skin-related side effects from your melanoma treatment, ask your oncologist if there is an oncodermatologist to which s/he can refer you.

To learn more, read an interview with a practicing oncodermatologist on our affiliate site, AIM at Skin Cancer, called What is Oncodermatology? – Everything You Need to Know.

 

References

1. Salah S, Kerob D, Laurent CP et al. EVALUATION OF ANTICANCER THERAPY- RELATED DERMATOLOGIC ADVERSE EVENTS: INSIGHTS FROM FDA’S FAERS DATASET. 2024;S0190-9622(24)02532-5. doi: 10.1016/j.jaad.2024.07.1456.

2. Freites-Martinez A, Apalla Z, Fattore D et al. Supportive oncodermatology practices in Europe and the USA. J Eur Acad Dermatol Venereol. 2024;38(5):e440-e443. doi: 10.1111/jdv.19679.

3. Dang T. What is Oncodermatology? – Everything You Need to Know. 2024. https://aimatskincancer.org/interviews-with-leading-dermatologists/what-is-oncodermatology-everything-you-need-to-know/. Accessed August 9, 2024.

4. Pinto C, Barone CA, Girolomoni G et al. Management of skin toxicity associated with cetuximab treatment in combination with chemotherapy or radiotherapy. Oncologist. 2011;16(2):228-38. doi: 10.1634/theoncologist.2010-0298.

5. Behroozian T, Goldshtein D, Wolf JR et al. MASCC clinical practice guidelines for the prevention and management of acute radiation dermatitis: part 1) systematic review. Lancet Oncol. 2023;58. doi: 10.1016/S1470-2045(23)00067-0

6. Girnita A, Bjerring P, Kauppi S et al. INDIVIDUAL ARTICLE: NECOM 3: A Practical Algorithm for the Management of Radiation Therapy-Related Acute Radiation Dermatitis. 2023;22(11): SF400354s3.

7. Betancourt NJ, Johnson AN, Clawson RC et al. Electronic consultation in supportive oncodermatology: a single center retrospective cohort. Derm Online J. 2024;30(1). doi: 10.5070/D330163303