Kanser ve ayak sağlığı: onkoloji hastalarına özgü podolojik yaklaşımlar

Abstract

Kanser, dünya genelinde yüksek mortalite ve morbidite oranlarına sahip karmaşık bir hastalık grubudur. Bu hastalık grubunda kullanılan tedavi yöntemleri, yaşam kalitesini önemli ölçüde etkileyen cilt ve tırnak toksisiteleri, el-ayak sendromu ve periferik nöropati gibi yan etkilere yol açabilmektedir. Podoloji bilimi, bu etkilerin önlenmesi ve yönetilmesi açısından kritik bir rol oynamaktadır. Bu derleme, kanser tedavilerinde sıkça görülen ayak sağlığı sorunlarını, bu sorunların patofizyolojisini ve multidisipliner yaklaşımla sunulabilecek podolojik çözümleri sistematik bir şekilde ele almayı amaçlamaktadır. Ayrıca, Podologlar ve onkoloji uzmanlarının iş birliği ile ayak sağlığının korunmasının tedavi sürecindeki katkıları vurgulanmıştır. Derlemede, kemoterapi, radyoterapi ve immünoterapinin ayak sağlığı üzerindeki etkileri detaylandırılmış ve bu etkilerin yönetimi için uygulamalı öneriler sunulmuştur.

Keywords

• Ayak deformiteleri
• kanser
• podolojik bakım
• tırnak toksisiteleri

Cancer and foot health: special podologic approaches to oncology patients

Abstract

Cancer comprises a heterogeneous group of diseases associated with substantial global mortality and morbidity. Therapeutic modalities for these diseases frequently produce adverse effects-most notably skin and nail toxicities, hand-foot syndrome (HFS; palmar-plantar erythrodysesthesia), and peripheral neuropathy-that can markedly diminish patients’ quality of life. Podiatric care is therefore critical for preventing and mitigating these sequelae. In this review, we systematically examine the foot-related complications of cancer therapy, describe their underlying pathophysiology, and delineate multidisciplinary podiatric interventions. We also highlight the benefits of close collaboration between podiatrists and oncology specialists in maintaining foot health during treatment. Finally, we summarise the specific effects of chemotherapy, radiotherapy, and immunotherapy on the feet and provide evidence-based recommendations for their management.

Keywords

• Cancer
• foot deformities
• nail toxicities
• podological care

References

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263. doi:10. 3322/caac.21834
2. Kayıkçı EE, Can G. The effect of salt-water bath in the management of treatment-related peripheral neuropathy in cancer patients receiving taxane and platinum-based treatment. Explore (NY). 2022;18(3):347-356. doi:10.1016/j.explore.2021.07.002
3. Wan M, Luo X, Wang J, et al. The impact on quality of life from informing diagnosis in patients with cancer: a systematic review and meta-analysis. BMC Cancer. 2020;20(1):618. doi:10.1186/s12885-020-07096-6
4. Tachi T, Teramachi H, Tanaka K, et al. The impact of outpatient chemotherapy-related adverse events on the quality of life of breast cancer patients. PLoS One. 2015;10(4):e0124169. doi:10.1371/journal.pone.0124169
5. Hagiwara Y, Shiroiwa T, Shimozuma K, et al. Impact of adverse events on health utility and health-related quality of life in patients receiving first-line chemotherapy for metastatic breast cancer: results from the SELECT BC study. Pharmacoeconomics. 2018;36:215-223. doi:10.1007/s40273-017-0580-7
6. Lacouture ME, Kopsky DJ, Lilker R, et al. Podiatric adverse events and foot care in cancer patients and survivors: awareness, education, and literature review. J Am Podiatr Med Assoc. 2018;108(6):508-516. doi:10. 7547/17-010
7. Palomo-López P, Rodríguez-Sanz D, Becerro-de-Bengoa-Vallejo R, et al. Clinical aspects of foot health and their influence on quality of life among breast cancer survivors: a case-control study. Cancer Manag Res. 2017;9:545-551. doi:10.2147/CMAR.S151343
8. Nádašiová M. Podiatry, podology and pedicure. Int J Health New Technol Soc Work. 2018;13(4):4-10.

9. Gilbar P, Hain A, Peereboom VM. Nail toxicity induced by cancer chemotherapy. J Oncol Pharm Pract. 2009;15(3):143-155. doi:10.1177/ 1078155208100450
10. Saadet ED, Tek I. Evaluation of chemotherapy-induced cutaneous side effects in cancer patients. Int J Dermatol. 2022;61(12):1519-1526. doi:10. 1111/ijd.16361
11. Pinto C, Barone CA, Girolomoni G, et al. Management of skin toxicity associated with cetuximab treatment in combination with chemotherapy or radiotherapy. Oncologist. 2011;16(2):228-238. doi:10. 1634/theoncologist.2010-0298
12. Fabbrocini G, Cameli N, Romano MC, et al. Chemotherapy and skin reactions. J Exp Clin Cancer Res. 2012;31(1):50. doi:10.1186/1756-9966-31-50
13. Li T, Perez-Soler R. Skin toxicities associated with epidermal growth factor receptor inhibitors. Target Oncol. 2009;4(2):107-119. doi:10.1007/s11523-009-0114-0
14. Piraccini BM, Iorizzo M, Antonucci A, Tosti A. Drug-induced nail abnormalities. Expert Opin Drug Saf. 2004;3(1):57-65. doi:10.1517/1474 0338.3.1.57
15. Singal A, Bisherwal K. Melanonychia: etiology, diagnosis, and treatment. Indian Dermatol Online J. 2020;11(1):1-11. doi:10.4103/idoj.IDOJ_167_19
16. Samson P, Curvale C, Iniesta A, Gay A. Managing longitudinal melanonychia. Hand Surg Rehabil. 2024;43S:101526. doi:10.1016/j.hansur.2022.12.007
17. Robert C, Sibaud V, Mateus C, et al. Nail toxicities induced by systemic anticancer treatments. Lancet Oncol. 2015;16(4):e181-e189. doi:10.1016/S1470-2045(14)71133-7
18. Alizadeh N, Mirpour SH, Darjani A, Rafiei R, Rafiei E, Mohammadhoseini M. Dermatologic adverse effects of breast cancer chemotherapy: a longitudinal prospective observational study with a review of literature. Int J Dermatol. 2020;59(7):822-828. doi:10.1111/ijd. 14916
19. Cuervo-Maldonado SI, Álvarez-Rodríguez JC, Cubides CL, et al. Fusariosis in cancer patients: 13 case series report and literature review. Biomedica. 2023;43(Sp. 1):41-56. doi:10.7705/biomedica.6925
20. Kwakman JJM, Elshot YS, Punt CJA, Koopman M. Management of cytotoxic chemotherapy-induced hand-foot syndrome. Oncol Rev. 2020; 14(1):442. doi:10.4081/oncol.2020.442
21. Miller KK, Gorcey L, McLellan BN. Chemotherapy-induced hand-foot syndrome and nail changes: a review of clinical presentation, etiology, pathogenesis, and management. J Am Acad Dermatol. 2014;71(4):787-794. doi:10.1016/j.jaad.2014.03.019
22. Li Y, Huang W, Zhang L, et al. Evaluation of the preventive effect of regional cooling nursing on hand-foot syndrome caused by doxorubicin hydrochloride liposome. Open J Nurs. 2022;12(11):772-781. doi:10.4236/ojn.2022.1211054
23. Bun S, Yunokawa M, Tamaki Y, et al. Symptom management: the utility of regional cooling for hand-foot syndrome induced by pegylated liposomal doxorubicin in ovarian cancer. Support Care Cancer. 2018;26: 2161-2166. doi:10.1007/s00520-018-4054-z
24. Tofthagen C, Overcash J, Kip K. Falls in persons with chemotherapy-induced peripheral neuropathy. Support Care Cancer. 2012;20(3):583-589. doi:10.1007/s00520-011-1127-7
25. Cathcart-Rake EJ, Hilliker DR, Loprinzi CL. Chemotherapy-induced neuropathy: central resolution of a peripherally perceived problem? Cancer. 2017;123(11):1898-1900. doi:10.1002/cncr.30650
26. Veiga-Seijo R, González-Bartol E, Pérez-Ríos N, Pazos-Couselo M, Romero-Bernárdez D, Seoane-Pillado T. Wellbeing and complementary therapies in breast cancer peripheral neuropathy care: a scoping review focused on foot health. Cancers (Basel). 2023;15(7):2110. doi:10.3390/cancers15072110
27. Čeović R, Kovačec L, Bukvić Mokos Z, Marinović B. Dermatologic adverse events in oncologic therapies. Acta Dermatovenerol Croat. 2022; 30(4):237-249.
28. Alley E, Green R, Schuchter L. Cutaneous toxicities of cancer therapy. Curr Opin Oncol. 2002;14(2):212-216. doi:10.1097/00001622-200203000-00012