Given the complexity of cancer treatment, skin care may seem like a small matter. But as anyone who has undergone radiation knows, a common side effect of the cancer treatment is developing sensitive skin.
Until now, cancer patients have been routinely advised for years to avoid using any moisturizer or any topical agent on the radiation field within four hours of treatment even though a moisturizer is viewed as a way to prevent unpleasant skin changes, including dry, itching, peeling or blistering skin, all common and distressing side effects of radiation.
That’s because in the medical world, one widely held theory is the presence of lotion can actually increase the risk of a bad skin reaction by inducing a ‘bolus effect’ that is, inadvertently making the skin thicker and thereby boosting the surface dose of radiation.
However, going without lotion can result in skin damage and discomfort, leading to infection and pain severe enough to interrupt the treatment and increase the chance that malignant cells will repopulate while the skin heals.
Trish Bieck, R.N, a nurse at the James P. Wilmot Cancer Center in Rochester, NY, knew firsthand that skin issues were a constant source of anxiety for many patients receiving radiation therapy, and through her research she discovered that long-held, routine advice was rooted more in myth than scientific evidence.
“It always bothered me that there didn’t seem to be any rationale behind restricting lotions during that particular timeframe,” said Bieck, who has worked in Radiation Oncology for 20 years. “When I looked into it, I discovered little evidence to support the four-hour policies. Instead, the practice was based on historical practice – in other words, ‘just because, that’s the way we do it.’ ’’
Bieck conducted a literature review of relevant articles published between 1992 and 2009, interviewed experts, examined benchmarks at international cancer centers, and consulted with professional organizations. Her findings, now published in the Clinical Journal of Oncology Nursing are prompting mindset and policy changes locally and across the country.