Principles of Skin Care and the Oncology Patient

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Preface

A few minutes after the nurse entered the exam room, the patient's head remained bowed, raising only to utter the words "I feel like I am on fire, and I am not sure I want to finish treatment." The patient just completed his fifth week of chemotherapy and radiation to his head and neck. Knowing the likely cause of the patient's discomfort, the oncology nurse immediately inspected the patient's skin. The treatment field, once pink, was now brightly erythematic, moist in the crease of his neck, and skin taut.

Oncology nurses face this situation every day in their clinical practice. Knowing when to expect skin reactions is easy, but it is the intervention that becomes a challenge. There are no standard guidelines to follow or quick pocket guides that contain algorithms. Often oncology nurses rely on their own clinical pearls to help the patient. In the opening scenario, the oncology nurse searches for the clinical evidence to treat the patient's skin reaction.

Principles of Skin Care and the Oncology Patient begins to address issues of skin care and helps to guide physicians, nurse practitioners/physician assistants, and nurses who care for patients with cancer who develop skin problems. Information about evidence-based principles and practice guidelines in caring for the oncology patient who has developed skin problems is presented. The chapters begin with an in-depth discussion about anatomy and physiology of the skin and accessory organs, including the healing process after injury. Also included is a review of common drug reactions that can cause cutaneous manifestations. Benign and malignant cutaneous diseases are presented. A nursing expert in wound and ostomy care shares clinical decision making when selecting wound care products and treatments. Skin reactions caused by radiation and chemotherapy are highlighted, and manifestations are discussed. A more specific topic of cutaneous effects from blood and marrow transplantation is shared, highlighting acute and chronic graft-versus-host disease. The topics of wound pain, psychological distress, nutritional needs for healing, chronic disease, systemic and infectious diseases, complementary therapies, and special needs of the gero-oncology patient are presented in relation to skin problems.

The following work begins to answer the opening concerns of the oncology nurse: Where is the supportive evidence to treat oncology patients with skin reactions? The efforts of many authors to synthesize scientific information have strengthened the quest to build a foundation of knowledge with the expectation to improve the quality of care for patients with cancer.