“I was in the prime of my youth, but when I learned I had a tumor, the mirror suddenly became my worst enemy.” Talking is Monica Forchetta, a young beautiful woman of 39 years old, who was diagnosed with stage four metastatic melanoma ten years ago. A tumor, therefore, quite aggressive which frightened Monica a lot but she – thanks to her innovative therapies – managed to get out of it. It happens more and more frequently: the data from the latest Aiom Report shows that in Italy there are one million Italians considered cured of cancer which in many patients becomes chronic. This is why today both doctors and patients also aim to improve the quality of life which sometimes passes through the skin on which the disease and treatments leave traces that show everyone their conditions, but above all they create psychological discomfort when not real pain or discomfort. own. The ‘Skin & Cancer’ project goes in this direction Pierre Fabre Italia (Eau Thermale Avène), in collaboration with the SIDeMaST (Italian Society of Medical, Surgical, Aesthetic Dermatology and Sexually Transmitted Diseases) ‘Ticuro’ task force and with the collaboration of the main Italian patient associations.
From despair to caring
In the collective imagination, when we talk about chemotherapy, the idea immediately refers to nausea and hair loss. Today there are also other oncological treatments and chemotherapy itself has evolved, but some inevitable side effects, including dermatological ones, remain. “I experienced all the side effects of the therapies I underwent, starting from a slight alopecia, skin rashes all over my body and flaking nails,” says Monica Forchetta who later founded APaIM (Italian Melanoma Patients Association) of which he is president. “The discouragement was enormous because when I looked in the mirror I no longer saw myself and I thought that I would never go back to how I was before the tumor and instead over time I regained confidence in myself and it was nice to learn to manage these too. side effects of therapies”.
Skin, nails, hair: the signs of cancer on the body
Some cancer therapies can directly or indirectly affect the cells that produce skin, nails and hair. At a dermatological level, some signs or symptoms may appear even a few days after starting therapy, while on hands and feet after weeks or even 6 months after starting treatment. “More than 80% of patients have side effects on the skin and in those with lung cancer treated with anti-Egfr it reaches almost 90%, more so in the elderly because they start from dry skin conditions for which the skin is more fragile,” he explains Pietro Sollena, dermatologist at the Agostino Gemelli University Polyclinic Foundation in Rome and coordinator of the SIDeMaST (Italian Society of Medical, Surgical, Aesthetic Dermatology and Sexually Transmitted Diseases) Task force ‘Ticuro’. “The most frequently reported problems are itching, dry skin, redness, flaking, alterations of the skin appendages with alopecia and nail problems, but there may also be inflammatory skin reactions which can cause pain and walking problems”.
Why not overlook these issues
Concerned first of all with understanding what the therapeutic procedure to follow to overcome the tumor will be, patients very often passively accept these side effects and do not have the courage to ask the oncologist for information: “The skin reactions and the dermatological effects in general – explains Davide Fattoredermatologist at the ‘The body found’ clinic dedicated to the prevention and treatment of skin toxicities during oncotherapy in the dermatology department directed by Massimiliano Scalvenzi at the University of Naples Federico II – are often underestimated but we should all pay more attention because the effects of oncological therapies on the skin not only cause significant repercussions on the quality of life, but can damage psychophysical well-being to the point of compromising continuity and therefore the effectiveness of the therapeutic process itself”.
The importance of teamwork
As emerges from the testimony of Monica Forchetta and that of other patients who like her live with a tumor and with dermatological problems related to treatments, there are also many implications on relationship and sexual life. Unfortunately, however, the dermatologist is often not part of the multidisciplinary team and is little or not at all involved in the registration studies of anti-cancer drugs. “The possibility of also having a dermatology service in the same center, with professionals with specific experience and skills in managing the skin problems of cancer patients, is essential for the development of the treatment plan and for the early identification of effects unwanted effects induced by therapies,” he declares Luigi Formisano, specialist in medical oncology at the Federico II University of Naples. “Correct management of skin toxicity will also be relevant in the future, given the ever-improving life expectancy of cancer patients”.
The ‘Skin & cancer’ project
Precisely from the awareness of how important it is today to also take into consideration the needs of the skin of an oncology patient and at the same time encourage greater collaboration between clinicians, Pierre Fabre Italia (Eau Thermale Avène) has developed the ‘Skin & cancer’ project carried out in collaboration with the SIDeMaST “Ticuro” task force and some of the main Italian patient associations (AIMa.Me., APaIM, Associazione Melanoma Italia Onlus, Europa Donna Italia, Fondazione IncontraDonna). “Starting from a position of listening to clinicians and patients, our goal is to optimize the treatment path by catalyzing the virtuous interaction between companies, clinicians and patients,” he explains David Turilli, General Manager Pierre Fabre Italy. “We have already held two multidisciplinary meetings that brought together clinicians and patient associations during which the need for greater awareness, information and training on these issues emerged”.
Eighteen answers for cancer patients
In addition to the training of medical specialists, a booklet has been created in which the specialists of the SIDeMaST task force explain how patients can take care of their skin during the therapeutic process by answering very practical questions such as, for example, what to do if you notice changes on skin, hair and nails; whether it is possible to expose yourself to the sun during treatments; how to take care of your scar after surgery or even whether you can wear makeup or shave.