A qualitative analysis of acute skin toxicity among breast cancer radiotherapy patients.
OBJECTIVE
One of the most common acute side effects of breast cancer radiotherapy is treatment-induced skin changes, referred to as skin toxicity. Yet no research to date has focused expressly on skin toxicity-related quality of life (QOL) in breast cancer radiotherapy patients. Therefore, our aim was to use qualitative approaches to better understand the impact of skin toxicity on QOL.


METHODS
Semistructured interviews were conducted with 20 women (Stage 0-III breast cancer), during their last week of external beam radiotherapy. Each interview was transcribed verbatim, and thematic analysis was performed.


RESULTS
Three themes were identified based on the interview responses: First, skin changes affect multiple dimensions of QOL. They cause physical discomfort, body image disturbance, emotional distress, and impair both day-to-day functioning and satisfaction with radiation treatment. Second, individual differences affect women's experiences. Generally African American women, younger women, women who are not currently in a relationship, women who are being treated during the summer, and women who are more invested in their appearance are more distressed by skin toxicity. Third, women use a variety of symptom management strategies including self-medication, complementary/alternative medicine approaches, and psychological strategies.


CONCLUSIONS
Implications of results are as follows: (1) skin toxicity affects numerous dimensions of QOL, and assessment approaches and psychosocial interventions should address this; (2) individual differences may affect the experience of skin toxicity and should be considered in treatment and education approaches; and (3) participants' own creativity and problem-solving should be used to improve the treatment experience.
Schnur
Julie B
JB
Department of Oncological Sciences and Integrative Behavioral Medicine Program, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. julie.schnur@mssm.edu
Ouellette
Suzanne C
SC
Dilorenzo
Terry A
TA
Green
Sheryl
S
Montgomery
Guy H
GH
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D011855:Radiodermatitis / Q000209:etiology / Q000473:pathology / Q000523:psychology*; D011878:Radiotherapy / Q000009:adverse effects; D012867:Skin / Q000473:pathology / Q000528:radiation effects*