Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T07:37:22.701Z Has data issue: false hasContentIssue false
  • English
  • Français

Are improvements needed in the management of severe acute skin reactions following completion of breast radiotherapy? A discussion of some possible service options

Published online by Cambridge University Press:  01 March 2009

J. Cumming  and
D. Routsis
J. Cumming*
Affiliation:
Pre-treatment Radiographer, Department of Oncology, Addenbrookes Hospital, Cambridge University NHS Trust, Hills Road, Cambridge, UK
D. Routsis
Affiliation:
Research Radiographer, Addenbrookes Hospital, Cambridge University NHS Trust, Hills Road, Cambridge, UK
*
Correspondence to: J. Cumming, Box 193, Department of Oncology, Addenbrookes Hospital, Cambridge University NHS Trust, Hills Road, Cambridge, CB2 0QQ, UK. E-mail: jade.cumming@addenbrookes.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Radiotherapy is a critical component for many patients undergoing treatment for breast cancer. Most patients develop some degree of acute radiation skin reaction as a result of the treatment. Acute skin reactions range from faint erythema to moist desquamation and often peak within 1 month after completion of treatment.

The emphasis of radiotherapy skincare advice is often during treatment with less attention paid to post-radiotherapy skincare. This article highlights this gap in service provision at one radiotherapy centre and demonstrates the difficulties encountered when there is an inadequate support system. Possible options are discussed for the management of skin reactions after radiotherapy and the potential implications of adopting these strategies. The pragmatic solution introduced to Addenbrookes’ Hospital was to amend patient information providing a supplementary section for health-care professionals overseeing patient care after completion of treatment. This has gone some way to addressing this issue but still has limitations.

Provision of timely and consistent skincare advice and support is vital to provide high-quality patient care. This article emphasises the importance of standardisation of radiotherapy skincare and providing an effective support network for patients after completion of radiotherapy.

Keywords

Acute skin reactionsskincarebreast cancerradiotherapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 8 , Issue 1 , March 2009 , pp. 11 - 16
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Harper, JL, Franklin, LE, Jenrette, JM, Aguero, EG.Skin toxicity during breast irradiation: pathophysiology and management. South Med J 2004; 97(10): 989–993.Google Scholar
Coles, C, Moody, M, Wilson, C, Burnet, N.Reduction of radiotherapy-induced late complications in early breast cancer: the role of intensity-modulated radiation therapy and partial breast irradiation. Part 1—normal tissue complications. Clin Oncol 2005; 17: 16–24.CrossRefGoogle Scholar
Aistars, J.The validity of skin care protocols followed by women with breast cancer receiving external radiation. Clin J Oncol Nurs 2006; 10(4): 487–492.CrossRefGoogle ScholarPubMed
Glean, E, Edwards, S, Faithfull, S, Meredith, C, Richards, C, Smith, M, Colyer, H.Intervention for acute radiotherapy induced skin reactions in cancer patients: the development of a clinical guideline recommended for use by the college of radiographers. J Radiother Pract 2001; 2: 75–84.Google Scholar
Bolderston, A, Lloyd, N, Wong, R, Holden, L, Robb-Blenderman, L; Supportive Care Guidelines Group of Cancer Care Ontario Program in Evidence-Based Care. The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer 2006; 14: 802–817.CrossRefGoogle ScholarPubMed
Boot-Vickers, M, Eaton, K.Skin care for patients receiving radiotherapy. Prof Nurse 1999; 14: 706–708.Google Scholar
Lavery, B.Skin care during radiotherapy: a survey of UK practice. Clin Oncol 1995; 7: 184–187.Google Scholar
Barkham, A.Radiotherapy skin reactions. Prof Nurse 1993; 732–735.Google Scholar
Wells, M, Macbride, S. Radiation Skin Reactions. In: Faithfull, S, Wells, M (eds). Supportive Care in Radiotherapy. Churchill Livingston, 2004.Google Scholar
McQuestion, M.Evidence-based skin care management in radiation therapy. Semin Oncol Nurs 2006; 22(3): 163–173.Google Scholar
Naylor, W, Mallet, J.Management of acute radiotherapy induced skin reactions: a literature review. Eur J Oncol Nurs 2001; 5(4): 221–233.CrossRefGoogle ScholarPubMed
Improving Communication in Cancer Care. Cancer Services Collaborative “Improvement Partnership” 2004. www.modern.nhs.uk/cancer.Google Scholar
NHS Quality Improvement Scotland. Best practice statement-skincare of patients receiving radiotherapy. www.nhshealthquality.org.Google Scholar
Hornsby, C, Fletcher, J, Blyth, C.The production of Best Practice Statement in the skincare of patients receiving radiotherapy. J Radiother Pract 2005; 4(2–3): 126–130.CrossRefGoogle Scholar
High Quality Care For All—NHS Next Stage Review Final Report 2008, www.dh.gov.uk.Google Scholar
Breakthrough Breast Cancer Report 2005. “What Breast Cancer Patients Want From A World Class Radiotherapy Service”Google Scholar
Improving Outcomes in Breast Cancer—Manual Update 2002. www.nice.org.uk.Google Scholar
Macmillan, M, Wells, M, Macbride, S, Raab, G, Munro, A, MacDougall, H.Randomized comparison of dry dressings versus hydrogel in management of radiation-induced moist desquamation. Int J Radiat Oncol Biol Phys 2007; 68(3): 864–872.Google Scholar