Striking Rash In A Patient With Lung Cancer On A Checkpoint Inhibitor
Georges E Tanios, MD,ab David G Morrison, MD, PhD,a and Reinhold Munker, MDab
aSection of Hematology and Medical Oncology, Department of Medicine, Tulane University, and bUniversity Medical Center, both in New Orleans, Louisiana
Accepted for publication February 14, 2018Correspondence Reinhold Munker, MD orGeorges E Tanios Disclosures The authors report no disclosures/conflicts of interest.Citation JCSO 2018 16:e159-e162
You May Like: How To Know If Its Skin Cancer
What Is The Treatment For Sarcoidosis
Fortunately, many patients with sarcoidosis require no treatment. Symptoms, after all, are usually not disabling and do tend to disappear spontaneously.
When therapy is recommended, the main goal is to keep the lungs and other affected body organs working and to relieve symptoms. The disease is considered inactive once the symptoms fade.
- Corticosteroid drugs remain the primary treatment for inflammation and granuloma formation.
- Prednisone is probably the corticosteroid most often prescribed today, but prednisolone is also used.
The doctors decision depends on the organ system involved and how far the inflammation has progressed. If the disease appears to be severe, especially in the lungs, eyes, heart, nervous system, spleen, or kidneys, the doctor may prescribe corticosteroids. There is no treatment at present to reverse the lung scarring that might be present in advanced sarcoidosis.
Is Cancer Causing The Itching
Itching related to cancer is sometimes identical to itching related to skin conditions or other benign causes, but there are some characteristics that may differ.
Signs of cancer-related itching may include:
- Itching in response to water, which is called aquagenic pruritus
- Lack of any rash or hives
- The presence of other symptoms such as a yellowish discoloration of the skin , and the B symptoms, which are body-wide symptoms of lymphoma including fever, weight loss, and drenching night sweats
In addition, itching associated with cancer may feel the worst on the lower legs and chest and may be associated with a burning sensation.
You May Like: Whats Cancer Look Like
How Is Lung Cancer Treated
Treatment will differ depending on the type and stage of the lung cancer. Examples of lung cancer treatment include:
- Surgery: To remove cancerous tissues
- Chemotherapy: Medication to help shrink or kill cancer
- Radiation therapy: High doses of radiation to kill cancer cells
- Targeted therapy: Medications to stop the spread and growth of cancer and reduce damage to healthy cells
- Immunotherapy: Stimulating the immune system to help fight cancer
Skin Rash And Good Performance Status Predict Improved Survival With Gefitinib For Patients With Advanced Non
Background: Gefitinib is active as a single agent for the treatment of advanced NSCLC patients who have failed prior chemotherapy. For optimal utilization of gefitinib, effective methods to identify sub-sets of patients likely to benefit from treatment are necessary. We analyzed patients treated with gefitinib on an Expanded Access Program at our institutions to detect possible predictive factors for patient selection to future studies. Methods: Patients with advanced NSCLC were treated with gefitinib upon progression from chemotherapy. Patients with ECOG PS of 2, adequate bone marrow, hepatic and renal function were eligible. Results: Baseline patient characteristics were: Median age: 68 years males 56% Adenocarcinoma 49%, squamous 21%, bronchioloalveolar-6%, other 24%. Objective partial responses were noted in 4 and disease stabilization in 28 patients. The median survival was 6.1 months and median time to progression was 3 months . The predictive factors analyzed were gender, skin rash, diarrhea and PS. Patients who developed a skin rash had a MS of 11 months compared to 4.5 months for patients without a rash . Patients with PS 0/1 and 2 had a MS of 5.8 months and 2.9 months respectively . Other factors did not impact survival. Occurence of skin rash and baseline PS of 0/1were associated with significantly improved survival for advanced NSCLC patients who failed prior chemotherapy, upon treatment with gefitinib.
Also Check: Invasive Ductal Carcinoma Grade 1 Survival Rate
Managing And Relieving Skin Problems
Rashes, dry skin, and nail and hair reactions are rarely severe. But they can cause major discomfort. Patients may even want to stop cancer treatment because of these reactions. It is important to talk with your health care team about what to expect. Also tell your doctor as soon as you start feeling or seeing any side effects. There are early and effective treatments for these reactions.
The following suggestions may help avoid reactions and help relieve them if they do happen:
Lung Cancer Symptoms In Women And Men
Lung cancer is the second most common type of cancer diagnosed in both men and women , according to the American Cancer Society . Only prostate cancer is more common for men, and breast cancer is more common for women.
However, lung cancer is the No. 1 cause of cancer death for both genders by far compared with other cancers. Below is a look at the statistics.
- About 119,100 men and 116,660 women are expected to be diagnosed with lung cancer in 2021, according to the ACS, with an estimated 69,410 deaths among men and 62,470 among women.
- The number of men diagnosed with lung cancer has decreased in the past four-plus decades, according to the American Lung Association. Diagnosis rates among women were on the rise during the same time period but have started to decline.
- Women tend to be diagnosed at an earlier age than men.
- Women who develop lung cancer before menopause are more likely to be diagnosed with advanced disease.
Recommended Reading: Prognosis Of Skin Cancer
Skin Cancer Rash: How To Assess Symptoms Similar To A Skin Rash Caused By Cancer
Whether caused by sunbathing or an allergic reaction, skin rashes may arise from a huge variety of conditions. However, certain rashes may indicate skin cancer, and being aware of potentially cancerous signs may help you get treatment quickly if needed.
In this article, well describe a few rashes to look out for and recommend when to seek medical attention. Helpful insights about skin cancer rash symptoms and types are provided below.
What Is A Respiratory Disease
A respiratory disease refers to any condition that affects the upper respiratory tract, trachea, lungs, and the nerves and muscles associated with breathing. The correct recognition of cutaneous signs of respiratory disease can aid clinicians in diagnosing and treating these potentially life-threatening diseases.
Also Check: What Does Well Differentiated Mean
Hodgkins Lymphoma Rash On Skin
Anaplastic large cell lymphoma, primary cutaneous type. This subtype of lymphoma only involves the skin. It is often indolent, although aggressive subtypes of the disease are possible. Anaplastic large cell lymphoma, systemic type. This aggressive form of lymphoma makes up about 2% of all lymphomas and about 10% of all childhood lymphomas.
Recommended Reading: Can Squamous Cell Carcinoma Metastasis
Superior Vena Cava Syndrome
Superior vena cava syndrome can be caused by lung cancers in the upper right lung and lymph nodes inside the chest. The superior vena cava is a major vein that carries blood from your head, neck, upper chest, and arms to the heart.
If a tumor compresses this vein, it can lead to symptoms such as difficulty breathing, shortness of breath, coughing, and swelling of your face, neck, upper body, and arms.
Read Also: Well-differentiated
Types Of Lung Cancer In Women And Men
The types of lung cancer differ among women and men as well:
- Women tend to develop NSCLC more than men.
- Women are more likely to be diagnosed with adenocarcinoma than men .
- Female nonsmokers are more likely than male nonsmokers to be diagnosed with the subtype bronchioalveolar carcinoma.
- Women who have lung cancer are more likely to live longer than men.
- Women who undergo surgery for some lung cancers, including NSCLC, also live longer than men. Women have a better response to chemotherapy treatments for lung cancer than men do.
- Men are more likely to be diagnosed with squamous cell carcinoma than women.
Small Cell Lung Cancer Symptoms
Most of the signs associated with small cell lung cancer are not present until the cancer has progressed. Typically, symptoms of SCLC continue to evolve and worsen as the disease spreads to distant organs.
Early symptoms of small cell lung cancer:
- Persistent cough
- Lumps in the neck or collarbone region
S Of Sarcoidosis On The Skin
Raised patches, deep lumps, or open sores
This is a common sign of sarcoidosis. The medical name for this sign is lupus pernio.
Unlike other signs that develop on the skin, this one only appears in people who have sarcoidosis. African American women are most likely to see this sign on their skin.
The patches and deep lumps tend to be red or reddish-purple. Some feel scaly.
Lupus pernio often appears on the nose and cheeks, but it can develop elsewhere. Some people get it on their lips, ears, fingers, or toes. While the patches and lumps are noticeable, they rarely cause any symptoms, such as pain or itch.
Lupus pernio often appears on the nose and cheeks
Common signs of sarcoidosis are raised patches, deep lumps, and sometimes open sores. The medical name is Lupus pernio.
Treatment is important, though. The patches can grow together, forming one large lesion that covers the nose and cheeks. If this happens, lumps and sores can develop inside the nose, causing nosebleeds and crusting around the nose. Without treatment, the lumps may spread to the respiratory tract, which can make breathing difficult or impossible.
Smooth bumps or growths
This is another common sign of sarcoidosis, especially among African American women. The medical name is papular sarcoidosis.
These bumps and growths tend to clear on their own without causing a scar.
Papular sarcoidosis often appears on the face, neck, or around eyes
Is Itching A Sign Of Cancer
- Only rarely does itching signal that a person has cancer.
- Some cancer treatments themselves may cause itching or rashes.
Got an itch that just wont go away? Also known as pruritus , itchy skin can have a wide variety of causes, including seasonal allergies and dry skin various skin conditions, such as eczema and even certain detergents and lotions.
The good news is that itchy skin is typically not a sign of cancer. This symptom may occur as a result of complications of the disease, and itchy, flaky skin and rashes are common side effects of some cancer drugs. Most skin cancers dont normally cause itching.
Anyone with a prolonged, unexplainable itch should consult either their primary care physician or a dermatologist.
Recommended Reading: Stage 3b Melanoma Survival Rate
Liver Bile Duct Pancreatic And Gallbladder Cancers
Any cancer that interferes with the bile ducts can lead to obstruction and the consequent build-up of bile salts in the skin. With pancreatic cancer specifically, this is most common with cancers located in the head of the pancreas. Other symptoms may include jaundice, abdominal pain, ascites , and abdominal pain.
Read Also: Soderstrom Skin Cancer Screening
Unexpected Signs And Symptoms Of Lung Cancer
What sort of symptoms would be considered unexpected, shocking, or surprising? These signs and symptoms dont appear to be related to our lungs. The general public would not expect these indicators or signals to be a warning of lung cancer.
You May Like: Lobular Breast Cancer Stage 3
Side Effects Of Cancer Treatment: Itching Overview
Medically reviewed by C.H. Weaver M.D. Medical Editor 8/2020
Pruritus is an uncomfortable skin sensation, commonly called itching. It may be caused by any number of irritants to the skin, or it may be a result of cancer treatments or cancer itself. Treatments aim to reduce inflammation, pain, or reverse an allergic reaction. Taking care of your skin will also help manage itching.
- What is pruritus?
- What are the symptoms to watch for?
- How is itching treated?
- What else can I do?
Paraneoplastic Syndromes And Lung Cancer
Sometimes, SCLC can cause paraneoplastic syndromes. While not always the case, these syndromes are often early signs of SCLC.
SCLC may cause one of these three paraneoplastic syndromes: Syndrome of Inappropriate Anti-Diuretic Hormone , Cushing Syndrome or Lambert-Eaton Syndrome. Symptoms of paraneoplastic syndromes include muscle cramps, muscle weakness, elevation of calcium in the blood and clubbing, which refers to a change in the shape of the finger tips.
You May Like: Cancer All Over Body Symptoms
Is It A Skin Cancer Rash
Rashes can occur for a wide variety of different reasons, so its difficult to determine if one could be cancer just by looking at it. Skin rashes are commonly caused by allergies, infections, exposure to heat, and irritation from chemicals such as in washing detergents.
However, certain types of unexplained rashes can be a sign of skin cancer. Most people think of moles and dark patches on the skin when they think about skin cancer, but a rash can also be associated with skin cancer.
The most effective way to identify a skin cancer rash is to examine your skin on a regular basis. If you notice an unexplained rash thats not going away on its own, it is recommended to visit a health care provider or dermatologist for advice.
Can Itching Be A Sign Of Cancer
Itchy skin can be a symptom of cancer or even the first sign of cancer, though other causes of itching are certainly much more common. Cancers commonly associated with itching include some leukemias and lymphomas, gallbladder cancer, and liver cancer. However, a number of other cancers may be implicated as well.
Also Check: Does Amelanotic Melanoma Blanch When Pressed
Recommended Reading: Invasive Lobular Breast Cancer Survival Rate
Earlier Detection Methods Are Needed
Our findings highlight the need for earlier detection of cancer, Dr. Curtis said.
Cancer researchers are already exploring noninvasive methods that could detect cancer at an early stage by analyzing tumor cells, or pieces of DNA from tumor cells, that have escaped from the original tumor and are found in the blood.
This approach, often called a liquid biopsy, could help doctors identify patients at risk for metastasis and treat them with chemotherapy or targeted therapies, if available, to try to eliminate metastatic cells that have spread in the body before surgery, Dr. Boudreau said.
This is early-stage research, but it gives us the first quantitative evidence that metastasis can occur exceedingly early, while also providing clues as to how to identify individuals who are at risk of metastasis, Dr. Curtis said.
Before the new results can be used to guide patient care, the researchers will need to look at a much larger group of patients, to see how consistent their findings are, Dr. Boudreau said.
Indeed, Dr. Curtis said, her team plans to extend their analysis to more patients. The biggest task, she said, will be to follow patients with earlier-stage colorectal cancer and investigate whether these specific combinations of mutations are indeed predictive of disease progression. And then, if thats true, we will have a rationale to go forward with clinical studies.
Read Also: Can Squamous Cell Carcinoma Metastasis
Liver Bile Duct Pancreatic And Gallbladder Cancer
Any cancer that interferes with the bile ducts can lead to obstruction and the consequent buildup of bile salts in the skin that can lead to itching.
With pancreatic cancer specifically, this buildup and itching is most common with cancers located in the head of the pancreas. Other symptoms may include yellowing of the skin, abdominal pain, a collection of fluid in the abdomen , and abdominal pain.
Recommended Reading: Melanoma Forearm
Targeted Drugs And Hormone Therapy
Some types of targeted cancer drugs and hormone therapy cause skin rashes.
Targeted cancer drugs called EGFR inhibitors are most likely to cause skin reactions such as a rash and itching. These include erlotinib and cetuximab.
If you have a severe rash, you may need treatment with steroid creams or tablets, or antibiotic creams or tablets.
Taking Care Of Your Skin During Treatment
In addition to discussing any skin changes with their doctor, patients can reduce the effect of treatment on their skin by using strategies such as:1,3
- Drink plenty of fluids, at least two liters daily. Hydration is critical for skin health.
- Use moisturizers, especially after showering or bathing when skin is still moist.
- Take baths or showers in warm, not hot, water.
- Use sun protection, including sunscreen, hats, long sleeves and pants.
- Use skin products that are alcohol-free, fragrance-free, and hypoallergenic to minimize irritation.
- Carefully manicure fingernails and toenails.
- Wear protective gloves during dish-washing or gardening.
- If spending a lot of time lying or sitting down, prevent pressure sores by shifting weight or changing position regularly.
- Avoid using heating pads or ice on areas receiving radiation therapy.
- Use an electric shaver rather than a razor.
- Keep room temperature cool and humid.
- Ask doctors or nurses for recommendations on skin products as well as any products to avoid. For example, patients may be asked not to use antiperspirant or powder while receiving radiation therapy.
Don’t Miss: Lobular Breast Cancer Survival Rate