Psychological effects of cetuximab-induced cutaneous rash in advanced colorectal cancer patients.
OBJECTIVE
Advanced colorectal cancer (CRC) has recently been treated with monoclonal antibodies, such as cetuximab. Skin toxicity is a peculiar side effect of cetuximab that may induce patients to interrupt therapy if it becomes serious. This study investigates the psychological and social sequelae of skin rash.


METHODS
Patients affected by advanced CRC and treated with cetuximab-based therapy entered the trial. The following questionnaires were used: the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) to measure quality of life (QoL) and the Psychological Distress Inventory (PDI). A single item regarding social avoidance was added with a three-point Likert scale. Toxicity was assessed using the National Cancer Institute Criteria (NCI-2).


RESULTS
Eighty patients were recruited; 41% presented psychological distress. As regards social avoidance, 53% of patients answered that they did not avoid going out at all. The rest of the sample answered that they "very much" (22%) or "somewhat" (25%) avoided going out. Psychological distress and social avoidance were not correlated to skin rash, but only to QoL.


CONCLUSIONS
Skin rash was not found to impact patients' psychological status or social life. Two likely explanations for this finding were that (a) patients with advanced cancer consider skin rash as a part of the complex suffering caused by cancer and (b) patients are encouraged by oncologists to continue treatment because skin rash is indicative of response to therapy. This expectation brings hope and helps patients bear the drug-related side effects.
Romito
Francesca
F
Experimental Unit of Psychological Oncology, Department of Critical Area and Surgery, National Cancer Institute Giovanni Paolo II, Via Hahnemann 10, 70100 Bari, Italy. francescaromito@yahoo.com
Giuliani
Francesco
F
Cormio
Claudia
C
Tulipani
Cinzia
C
Mattioli
Vittorio
V
Colucci
Giuseppe
G
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001007:Anxiety / Q000523:psychology*; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003875:Drug Eruptions / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011159:Population Surveillance / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D012919:Social Behavior; D011795:Surveys and Questionnaires
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068818:Cetuximab