What should I do when anti-tumor therapy encounters "hand-foot syndrome"? Try these tips

#长沙头条##湖南省中西医结合医院#

Hand-foot syndrome (HFS) is a common skin toxicity caused by chemotherapy, targeted drugs and other treatments, including skin redness, blisters, hyperkeratosis, pain, paresthesias and sensory disorders, etc., these symptoms usually appear on the palms and soles of the feet, mostly during or after treatment, the symptoms will gradually disappear after stopping the drug, and the symptoms will reappear when the drug is taken again.

In mild cases, paresthesias, erythema, and desquamation of the hands and feet may occur; In severe cases, blisters, peeling or oozing, and even ulcers, and secondary infections may occur, and in severe cases, it can affect the daily life of patients and lead to a decrease in quality of life.

The pathogenesis of HFS is still unclear in modern medicine, and there are no effective preventive drugs. However, combining the different advantages of traditional Chinese medicine and Western medicine, the use of integrated Chinese and Western medicine treatment methods to prevent and treat hand-foot syndrome can achieve the purpose of improving related symptoms!

1. What drugs can trigger hand-foot syndrome?

Common chemotherapy drugs that cause hand-foot syndrome include capecitabine, fluorouracil, gemcitabine, paclitaxel, vinorelbine, etc.; Targeted drugs include apatinib, sorafenib, sunitinib, osimertinib, etc.

The incidence of hand-foot syndrome varies depending on the drug. Typical clinical symptoms include:

1. In the early stage, it manifests as redness of the skin on the palms and soles of the feet, and gradually develops into erythema, swelling, stinging, and some skin pigmentation (darkening), and in severe cases, blisters and ulcers may appear;

2. Swelling and pain at the ends of the hands and feet, paresthesia;

3. Dry, scaling, peeling skin of hands and feet, sometimes accompanied by itching;

4. In severe cases, secondary skin infections may occur.

2. What factors increase the risk of hand-foot syndrome?

In addition to the occurrence of hand-foot syndrome, which is related to the use of tumor chemotherapy and targeted drugs, the occurrence of hand-foot syndrome also includes the presence of some other risk factors:

1. Physical constitution and age, it is more likely to occur in patients with weak constitution or elderly patients;

2. The dosage and duration of medications, high doses or prolonged use of certain drugs may increase the risk of occurrence;

3. Other health problems: such as diabetes, unstable blood sugar, various vascular immune diseases, etc.

3. How to alleviate and treat hand-foot syndrome?

1. Traditional Chinese medicine treatment

In traditional Chinese medicine, symptoms such as hand-foot syndrome are collectively referred to as "paralysis", and most of the hand-foot syndrome caused by tumor treatment is based on deficiency of qi and blood, and stasis and obstruction of the network. Therefore, the treatment pays attention to "internal and external use", and needs to be treated both internally and externally.

The proposed prescription can be used at any time of chemotherapy or targeted therapy, or alternately with chemotherapy and targeted therapy, which has a certain effect on preventing or alleviating the symptoms of hand-foot syndrome.

(1) Traditional Chinese medicine treatment

According to the patient's physique and disease stage, professional TCM physicians choose Chinese herbal medicines with the effects of "nourishing qi and nourishing blood, removing blood stasis and channeling, dispelling wind and moistening dryness", such as astragalus, angelica, rehman, white peony, etc.;

These drugs can help improve the health of qi and blood in the patient's body, dredge the meridians, and relieve symptoms such as numbness, itching, and tingling in the hands and feet.

(2) External treatment of traditional Chinese medicine

(1) Acupuncture treatment: it can stimulate acupuncture points, reconcile qi and blood, warm and clear meridians, and achieve the purpose of relieving numbness; According to the specific situation of the patient, the specialist will select the appropriate meridians and take acupoints for phased treatment;

(2) Moxibustion treatment: Moxibustion has the effect of warming the meridians, dissipating cold and relieving pain, which is helpful for alleviating the warmth of the limbs caused by deficiency and cold constitution, accompanied by numbness of the hands and feet after treatment;

(3) Tuina massage: If the numbness and pain at the end of the limbs are obvious, and the skin is intact without ulcers or obvious redness and swelling, you can use a professional physician to massage the relevant parts as appropriate to help relieve the local pain and itching;

(4) Traditional Chinese medicine fumigation: Under normal skin conditions, the patient's skin is formulated by a professional Chinese medicine physician and fumigated or soaked in the affected area by decoction of traditional Chinese medicine decoction pieces, which can help improve the local circulation of the affected limb, promote the absorption of the liquid medicine into the skin, and directly reach the affected area, which is conducive to reducing local symptoms.

2. Western medicine treatment

Patients need to have adequate nutritional support to strengthen the body's resistance. Depending on the severity of the patient's side effects, the doctor will adjust the dose or type of treatment medication appropriately to reduce the damage to the nerve endings caused by the side effects of the drug.

At the same time, some topical or internal drugs are used to relieve the symptoms of hand-foot syndrome.

In case of dry and chapped skin, it is recommended to use drugs with moisturizing and anti-keratinizing effects, such as urea ointment; For severe skin redness, swelling and pain, oral antibiotics will be given, combined with some hormone-containing ointments or sprays for external use to reduce symptoms; If the extremities are numb and painful at the ends, it will be recommended to add drugs with antineuralgia, such as celecoxib or prei Bahrain capsules, and some patients will also be recommended to use vitamin B to assist in nutritional nerves.

4. How to recuperate in daily life?

1. Avoid excessive exposure to sunlight, wear soft, breathable shoes and socks to reduce skin friction in the affected area;

2. Keep your skin clean by using moisturizer or hand cream in advance to keep the skin on your hands and feet moisturized and reduce water loss.

3. Maintain a good and regular work and rest and eating habits, balanced nutrition, and enhance the body's resistance;

4. Follow the guidance and advice of a professional doctor, and use some medications if necessary to relieve related symptoms;

5. In severe cases, contact and truthfully inform the physician in charge, suspend or adjust the dosage of the drug, and seek professional treatment advice for the next step.

Experts remind

Tang Wei, director of the Fourth Department of Oncology of Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine), reminded that the treatment of clinical tumor hand and foot syndrome with the combination of traditional Chinese and Western medicine has better efficacy, which can regulate the physical state of patients during and after treatment while relieving local symptoms, which helps to improve the comprehensive efficacy and better cope with the side effects caused by chemotherapy, target immune therapy and other treatments.

During hospitalization, patients should be instructed to maintain a positive and optimistic attitude and reduce negative emotions; After being discharged from the hospital, it is also very important to be accompanied by family and friends to give corresponding emotional support, which will help you recover from cancer treatment in the later stage!

Hunan Medical Chat Special Author: Peng Lijuan, Department of Oncology, Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine).

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(Editor YT)