- the cancer patient is at risk for numerous treatment and
disease-related skin impairments, including:
- effects of chemotherapy, radiation and surgery
- pressure sores
- edema, ascites and lymphedema
- cutaneous metastases
- some effects of chemotherapy include: hyper pigmentation, hypersensitivity, photosensitivity, rash, nail changes
- some effects of radiation include: dry or moist desquamation, edema, radiation recall
- alopecia is a particularly distressing side effect for some cancer patients
- focus on the patient's current skin condition and any significant past skin problems
- observe color, vascularity, evidence of bleeding or bruising, presence of lesions, pressure sores , edema
- describe any skin changes carefully, including location, duration, onset, aggravating and relieving factors, treatments and characteristics
- review all medications as potential causes
- the goal is to maintain skin's natural integrity
- encourage meticulous hygiene, keep skin clean and dry
- assess high risk areas daily
- promote adequate nutritional intake
- protect affected areas from trauma
- encourage patients to get a wig prior to anticipated hair loss,
- identify sources of funding and places to obtain wigs, scarves and other head coverings; the American Cancer Society can help with this
- minimize hair loss with baby shampoos, soft hairbrush, infrequent washings, hair net in bed (in some cases, these measures may not make a difference)
- encourage use of sunscreens, hats to protect scalp
- encourage verbalization of feelings, fears about hair loss
Couillard-Getreuer, DL and Heery, ML (1994) "Protective Mechanisms - Skin" in Gross, J. and Johnson, BL (eds) Handbook of Oncology Nursing, 2nd ed., Boston: Jones and Bartlett, p. 421-463.
DeSpain, JD (1992)" Dermatologic Toxicity" in Perry, MC (ed) The Chemotherapy Source Book, Baltimore: Williams and Wilkins, p. 531-547.
Goodman, M, Hilderley, LJ, Purl, S. (1997). "Integumentary and Mucus Membrane Alterations" in Groenwald, SL, Frogge, MH, Goodman, M, Yarbro, CH, Cancer Nursing: Principles and Practice, 4th ed Boston: Jones and Bartlett, p. 768-822.
Sitton, E. (1992) Early and late radiation-induced skin alterations: Part II Nursing care of irradiated skin. Oncology Nursing Forum, 19: 907-912.