How do you manage grade 3 dermatitis during chemoradiation therapy for anal cancer?

This is a great question for this forum because management of skin toxicity is so dependent on personal and local experience. I’m interested to see what others have to say!

At baseline: apply lotion such as radiaplex or aquaphor to skin, keep area clean, limit skin chafing by wearing loose fitting cl...

Hi. Great question. In my years (~25 or so) - My usual skincare regimen is delivered in the sequence of:

1) Start off with corn starch baby powder - lessens friction rubs in high risk areas (delays the reaction - not speed it up) between the Gluteal folds and inguinal regions --->> 2) Then I transit...

I agree with my colleagues above that prevention is the best approach. To that end, I emphatically believe that having a patient do sitz baths from the time they start treatment is particularly useful. It seems that for the most part, women (particularly those who have had children) are more recepti...

(I'll rant and say as a specialty we have been woefully lax with evidence-based medicine studies looking at radiation-related skin care... we should do better. As questions like yours and the answers you're sure to get remind me of that line from 'The Big Lebowski': "That's just, like, your opinion,...

I have found topical products to be only mildly helpful. Many patients need some form of oral pain meds, narcotic/nsaids similar to head and neck patients, although these can be constipating. As in head and neck, I have found neurontin helpful for burning/neuropathic pain.

The issue with neurontin is...

I would add a couple of simple maneuvers. As noted above, feces (and urine) are local irritants. I advise patients to avoid dry toilet paper and to gently cleanse with baby wipes and then to irrigate the perineum with a hand held shower head. I tell them early on to consider modifying their shower i...

In addition to the many effective methods noted above, I have my patients focus on maintaining excellent hygiene. One means is by providing a Pericare bottle to each patient so they are not relying exclusively on toilet paper or wipes to cleanse the perianal area after bowel movements. I've found th...