Itching and cancer
Itching, also known as pruritus, is a common sensation characterized by the overwhelming urge to scratch the skin. This condition can arise in cancer patients due to various factors, including the cancer itself and treatments such as chemotherapy, radiation therapy, and certain medications. Various cancers, particularly lymphomas, leukemias, and skin-related cancers like squamous cell carcinoma, may also induce itching. The sensation stems from the stimulation of skin receptors, which can be triggered by factors like dryness, inflammation, or irritants.
While itching can lead to frustration and discomfort, it is not always reported as a significant issue by patients undergoing treatment. Management often focuses on addressing the underlying cause, but additional relief can be sought through moisturizing lotions, avoiding irritants, and making environmental adjustments. Although scratching might provide temporary relief, it can exacerbate the problem, leading to a cycle of irritation. Generally, the prognosis for itching is positive, with symptoms typically resolving after treatment or once the causative agent is removed. Preventative measures, including good skin care and hydration, can help minimize the risk of developing itching.
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Itching and cancer
ALSO KNOWN AS: Pruritus
RELATED CONDITIONS: Cancers treated with drugs, immunotherapy, targeted therapy, or radiation
DEFINITION: Itching is the overwhelming feeling of the need to scratch the skin. Many cancer treatments and some cancers can cause it, and it can lead to frustration, anxiety, and sleeplessness, as well as tearing of the skin and infection.
Risk factors: Many cancer treatment options are associated with an increased risk of itching. These include radiation therapy, chemotherapy, and many medications. Individuals who are undergoing both chemotherapy and radiation therapy at the same time are at an especially increased risk for itching. Some cancers also may cause itching, including lymphoma, leukemia, invasive squamous cell carcinoma, and Kaposi sarcoma. Individuals with cancers of the lung, breast, pancreatic, colon, stomach, and prostate may be at an increased risk of itching, as may individuals with tumors occurring on the spinal cord or brain.
Etiology and the disease process: A sensation of itching is caused when the receptors in the skin called purireceptors are stimulated. This stimulation can occur due to skin dryness, an excess of dead skin cells, an inflammation of the area, or other skin problems. The receptors can also be stimulated by things that are not on or around the skin, such as an allergic reaction to an ingested chemical. Once these purireceptors are stimulated, they send signals along specialized nerve fibers similar to the fibers that carry information about pain. The signals travel along the nerves to the brain, where the signals are interpreted by the brain to produce the feeling of itching.
The biological reasons that scratching can relieve the feeling of itching are not completely clear. There are many theories on the interaction of scratching and itching, including that scratching activates pain receptors, causing the brain to release chemicals to reduce the sensation of pain, which may decrease the feeling of itching. Another theory is that the scratching is also an irritation at the same site as the itching and causes the brain to become distracted from the original sensation. Although scratching the itch can lead to a temporary feeling of relief, it can also begin a negative cycle in which every scratch makes the itch worse. This may be because scratching the skin, especially with sharp nails, can irritate the skin, worsening the original problem.
Incidence: It is not certain how many cancer patients experience itching at some time during treatment. In many cases, it is not severe enough for patients to report it as a specific problem to their cancer care team.
Symptoms: The main symptom of itching is a sensation that causes a desire or need to scratch the affected area.
Screening and diagnosis: When patients report a problem with itching, their doctor will try to find an underlying cause. In some cases, the cause may become obvious through visual inspection. In other cases, no obvious cause may be found. The doctor may perform tests to determine if the itching is caused by an undetected underlying disease, such as or Hodgkin's disease. The doctor may also order blood tests to check for diseases other than cancer that can cause itching, such as liver disorders or kidney disease.
Treatment and therapy: The primary treatment for itching is to treat the underlying disease or condition that is causing the itching. However, while the underlying problem is being treated, or if no cause can be found, there are other ways to provide some relief.
Using lotions or creams to provide moisture to dry skin may help relieve itching. Reducing irritants by not using perfumes, traditional razors, or deodorants may be helpful. Washing sheets and clothes in mild detergents or using an extra rinse cycle can help avoid irritating detergent residues. Tight, confining clothes can irritate the skin. Choosing loose clothing made of cotton may help reduce itching. Very hot water can dry skin out, so taking short, warm baths, especially with oatmeal or bath oils added to the water, may be helpful.
Hot, dry weather can increase skin irritation, so keeping rooms cool and humid may provide relief. Scratching can make the itch worse and can lead to tears in the skin, which can become infected. Instead of scratching, it may be helpful to put ice or a cool washcloth on the area or to use vibration to dull the itching sensation.
Prognosis, prevention, and outcomes: The prognosis of itching is usually good. Itching caused by cancer generally clears up after the cancer has been treated. When itching is caused by chemotherapy, the itching usually stops between thirty and ninety minutes after the treatment ends. Itching caused by radiation therapy usually clears up when the skin at the site of the radiation heals. Itching, which is a side effect of a medication, generally ends when the individual has been off the medication for a short time.
The best way to prevent itching is for patients to take good care of their skin. Drinking plenty of fluids can help keep the body hydrated, which can prevent dry skin. Eating a healthy diet with a variety of fruits, vegetables, whole grains, and lean proteins may also help improve overall skin health.
Bibliography
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