Supplement Individual Article: NECOM Skincare Algorithm for Patients With Cancer and Survivors

January 2023 | Volume 22 | Issue 1 | 3595573 | Copyright © January 2023


Published online January 1, 2023

Ada Girnita MD PhDa, Peter Bjerring MD PhD FEADVb, Sampsa Kauppi MDc, Charles W. Lynde MD FRCPCd, Maxwell B. Sauder MD FRCPC DABDe, Anneke Andriessen PhDf

aSkin Cancer Center, Karolinska University Hospital, Stockholm, Sweden
bDepartment of Dermatology, Aalborg University Hospital, Aalborg, Denmark
cPrivate practice, Terveystalo and Epilaser Oy, Finland
dDepartment of Medicine University of Toronto, Toronto, ON, Canada; Lynderm Research, Markham, ON, Canada
ePrincess Margaret Cancer Centre, Toronto, ON, Canada; Department of Medicine University of Toronto, Toronto, ON, Canada
fRadboud UMC, Nijmegen and Andriessen Consultants, Malden, The Netherlands

Abstract
Background: Cancer treatment-related cutaneous adverse events (cAEs) frequently occur, which can interfere with anticancer treatment outcomes and can severely impact quality of life for patients.
Methods: The Nordic European Cutaneous Oncodermatology Management (NECOM) project aims to improve cancer patient outcomes by offering tools for preventing and managing cAEs. The first NECOM paper explored clinical insights in cAEs and focused on skincare regimens involving hygiene, moisturization, sun protection, and camouflage products. A skincare algorithm for patients with cancer and survivors follows this article to promote healthy skin and reduce cancer treatment-related cAEs.
Results: The NECOM panel discussed and reached a consensus on an evidence- and opinion-based practical algorithm for oncology skin care to support all stakeholders in the Nordic European health care setting. The oncology nurse is central in coordinating individual patient’s cancer care and performing triage for cAEs, seeking urgent care via an oncologist and/or the emergency department if needed. The care organization of the presented cAEs depends on the patient's general health and skin condition and the health care system.
Conclusion: Communication on state-of-the-art treatment in the fast-evolving area of oncology is necessary to provide tailored general measures and skin care for cAEs supported by evidence and practice-based expert recommendations.

J Drugs Dermatol. 2023;22:1(Suppl 2):s3-10.

INTRODUCTION

The 4 most commonly diagnosed cancers in the Nordic European countries in 2020 were lung, breast, prostate, and colorectal, accounting for almost half of all cancer diagnoses (175,925).1 The estimated global incidence of cancer per 100,000 population in 2020 in Denmark was 350; Norway, 325; Sweden, 285; Finland, 270; and Iceland, 260.2

According to the Swedish National Cancer Register, these statistics exclude skin cancer, which comes in third place after breast and prostate cancers.2 Basal cell cancer accounts yearly for more than breast and prostate cancers for over 50,000 new cases versus 10,000 and 9,000 cases, respectively.2 Increasingly, more patients live with or survive cancer due to an early diagnosis and an improved quality of cancer treatment.3

In the Nordic European countries in 2010, the relative 5-year cancer survival percentage of males and females in Sweden was 70% and 69%; in Finland, 65% and 68%; Denmark was 62% and 65%; respectively, and in Norway for either gender, 69%.3

More people live with or survive cancer and have cancer treatment-related cAEs or sequelae.4-9,13-29 Cancer treatment-related cutaneous adverse events (cAEs) frequently occur, interfering with anticancer treatment outcomes and severely impacting quality of life (QoL) for patients.4,5,21-23,30-39 However, cAEs may indicate a therapeutic response.36

Patients most frequently report dermatologic adverse events as negatively impacting their QoL.6 The cAEs were unanticipated before therapy, and 67% of patients reported that cAEs were worse than their initial belief before starting cancer treatment despite the information given by health care providers.6 Another study showed that 58% of patients rated chemotherapy-induced alopecia as their therapy's most traumatic side effect, and 8%