Aesthetic Treatments for the Oncology Patient

Paloma Tejero, Hernán Pinto, Paloma Tejero, Hernán Pinto

• Publisher: CRC Press
• Year: 2020
• Print ISBN: 9780367568795
• eBook ISBN: 9781351395069
• Edition: 1
• Topic: Medicine
• Subtopic: Dermatology

Physicians are increasingly recognizing that helping a cancer patient feel good about themselves and about their appearance can be of vital importance in giving them the emotional support and psychological resilience to survive and recover from the side-effects of disease and its treatment. Dermatologists and other aesthetic physicians are in a prime position to help a cancer patient recover lost volume, hydration, and pigmentation in skin, nails, and hair, as well as to advise on nutrition, prostheses, and complentary therapies. This pioneering volume will be an important resource bringing together the expertise in this area, with the practical detail a physician will need.

1

The Oncological Patient and Aesthetic Medicine: The Bonded Approach

Paloma Tejero and Hernán Pinto

Aesthetic Medicine is a new field of medicine, in which different specialists share the objective of building and reconstructing the physical balance of the individual. Treatment of physical aesthetic alterations and unsightly sequelae of diseases or injuries, coupled with the prevention of aging, are perhaps two of the most emblematic areas of aesthetic medicine intervention [1].

J.J. Legrand

General Secretary of the International Union of Aesthetic Medicine (UIME)

Introduction

The incidence of cancer is increasing gradually in the populations of developed countries. According to the Europe against Cancer Program, in the next few years, two out of every three Europeans will have cancer [2]. Globocan [3] published that the number of new cases in 2018, worldwide, was 18,078,957. Population estimates indicate that the number of new cases will probably increase by 70% in the coming decades, reaching approximately 24 million cases in the year 2035 [4].

Despite having increased in incidence, survival has also increased. Approximately 67% of cancer survivors are currently living with a diagnosis of cancer made 5 or more years previously. All this is due to an increasingly early diagnosis, to the coordination of several medical specialties in the diagnosis, and to the use of increasingly effective treatment protocols.

The current guidelines of the American Society of Clinical Oncology (ASCO), the European Society for Medical Oncology (ESMO), and the World Health Organization (WHO) define the need to approach the oncological patient from the point of view of “continuous care,” defined as the integral attention to patients in their complete reality—biological, psychological, familial, work, and social [5]. Continuous care is applicable throughout the evolutionary process of cancer and its different stages.

Often, “the line between beauty and health is extremely fine” [7]. The classic phrase, “the face is the mirror of the soul,” explains that our state of mind, how we feel, and also our state of health can be reflected in our image. The face is also our business card that distinguishes us as a person different from others, which is why cancer is a stigmatizing disease for many patients, not only because of its direct effects, as in skin or head and neck tumors, but also because of the aftermath of many of their treatments.

The Oncological Patient

The number of cancer patients, or of those with a history of having an oncological disease, who require medical consultation for aesthetic reasons, is increasing rapidly.

As the overall death rate from cancer has declined, the number of cancer survivors has increased. Currently, 5% of the population are cancer survivors [8]. These trends show that progress is being made against the disease, but there is still a lot of work to be done. It is currently estimated that more than 30% of cancer cases could be avoided with healthy habits, but while smoking rates (smoking is a leading cause of cancer) have declined, the population is aging, and cancer rates increase with age. Additionally, obesity, a risk factor for many types of cancer, is on the rise [10].

In 2011, Tarsilo Ferro and Josep M. Borras [11] warned that “A snowball is growing in health services: surviving patients with cancer.” Many of today’s oncology patients will evolve into chronic patients who need to achieve quality of life standards that are part of what we call “the challenges of survival”: they want to live not only longer but also in the best possible way. The greater life expectancy and improved results from oncology treatment lead the oncological patient increasingly to demand medical-aesthetic cosmetic and reparative treatments that minimize adverse effects and stigmas linked to their disease. In a paper published in 2010, in the Latin American Journal of Nursing, that aimed to identify the stress factors present in the lives of women in the period of 1–5 years postdiagnosis, “the results indicated conflicts with self-image, alteration in the sensation of self-sufficiency, fear in relation to the evolution of the illness, the feeling of guilt for the disorder generated in the family, the experience of disturbing social situations, and the desire to return to professional occupation” [9].

Patients experience a strong emotional impact when receiving the news of their diagnosis; their personal, work, and social life change radically in a short time. In addition, they have to face aggressive treatments and the side effects of these treatments that tend to cause significant physical deterioration leading to loss of self-esteem. A low mood increases the levels of cortisol in the blood, damaging the immune system, affecting the state of well-being and health. Oncologists, and the medical community in general, increasingly recognize that treating the patient in a holistic way improves the results of treatment. This is where the role of aesthetic medicine is fundamental in oncology, since it intervenes at several levels: in prevention, during treatment (chemotherapy, radiotherapy, hormonotherapy, immunotherapy, and postsurgery), and in minimizing side effects (alterations in the skin and nails, mucositis, burns, alopecia, loss of eyebrows, vaginal dryness, lymphedema, weight loss, nausea and vomiting, sleep problems, problems in sexual relations, digestive disorders, etc.).

We know that the maintenance and improvement of quality of life is one of the key objectives of the care received by the patient. Since the 1990s, the evaluation of and the search for improvement of the quality of life of these patients have increased significantly. Quality of life is currently one of the key variables in oncology, as important as other medical variables (survival or response to treatment) [12], and it should guide therapeutic behavior, which must always be multidisciplinary. The preservation of a good self-image for the patient has a fundamental role in enabling the patient to avoid stigmatization (as the consequences of cancer on the skin, the self-image, and the body functions all betray its presence) and to enhance self-esteem and thus also to favor the immune response and adaptation to changes linked to the disease. Today no one doubts the therapeutic power of self-image [13] and the role that aesthetic medicine has to have in the continuum of the disease.

One aspect that we cannot forget is the number of patients diagnosed at young ages in whom the maintenance of an ability to work is essential for their lives. According to Stone [14], in 2017, 63% of cancer survivors continued to work or returned to work after treatment. Among this population, the ability to work and the challenges encountered in the workplace by these cancer survivors have not been well established, but we do know that the possibility of reducing labor productivity due to decreased capacity—functional, cognitive, and physical (changes in appearance, scars, etc.) changes caused by cancer and its treatments—significantly affects the reintegration of the patient into work and causes insecurity, anguish, and fear in a patient.

Aesthetic Medicine

Physical beauty has become so relevant in Western culture that many people consider physical appearance a major factor in their lives. The number of patients requiring medical consultation is increasing rapidly for aesthetic reasons. Aspects such as acceptance and its impact on self-esteem are considered increasingly important in the process of social adaptation. A dysmorphophobic, negative perception of one’s appearance can lead to pathologies (dysmorphisms and dysmorphobias). Psychosomatic disorders resulting from low self-esteem due to aesthetic reasons are frequent and cannot be ignored by doctors, who will have to respond to the aesthetic needs of their patients, seeking health according to WHO, which defines it as “a state of complete physical, mental and social well-being and not only the absence of affections or illnesses”; so, without a doubt, we have to prepare ourselves to work as a team. Beauty, based on a concept of health, is a social good, and therefore beneficial for everyone. Beauty thus understood reaches both healthy individuals and those with pathologies.

Aesthetic medicine began in France in the early 1970s, establishing the French Society of Aesthetic Medicine, founded by Dr. J.J. Legrand, and soon spread to Italy, Belgium, and Spain. Its main objective was to meet social needs and demands that the official medical specialties did not treat, in that they were limited to diseases. In 1976, these four national societies created the UIME (Union Internationale de Medecine Esthetique) based in Paris, which currently has members in 32 European and non-European countries, with the aim of gathering all over the world, in a single scientific program, doctors of different specialties but with a common interest in the problems related to aesthetic medicine [15].

The General Assembly of the Medical Collegial Organization of Spain approved in 2004 the need to create a National Register of Aesthetic Medicine Doctors and approved the proposal of the organizations consulted to define aesthetic medicine as the “combination of prescriptions, actions, techniques and medical and/or surgi...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Contributors
• 1. The Oncological Patient and Aesthetic Medicine: The Bonded Approach
• 2. Challenges for Oncology: Prevention, Palliation, and Survival
• 3. Cancer as a Chronic Disease
• 4. Clinical Record: Oncological Screening
• 5. Tumor Markers
• 6. The Psychological Approach: The Healing Power of Image and Comprehensive Assistance to Cancer Patients
• 7. The Role of the Family
• 8. The Oncological Patient Environment: Legal Framework and Ethics
• 9. Radiotherapy: The Prevention of Secondary Effects, Radiodermatitis, and Long-Term Toxicity
• 10. Prevention and Treatment of Dermatological Secondary Effects of Cancer Therapy
• 11. Prevention and Treatment of Adverse Effects of Antineoplastic Therapy and of Delayed-Onset Side Effects: Prevention and Treatment of Hair Loss
• 12. Melatonin for Prevention and Treatment of Complications Associated with Chemotherapy and Radiotherapy: Implications for Cancer Stem Cell Differentiation
• 13. Chronic Antineoplastic Therapies and Their Impact on Quality of Life
• 14. Interactions with Medical-Aesthetic Treatments
• 15. Medical-Aesthetic Treatments in the Survivor Patient
• 16. Medical-Aesthetic Treatments in Oncology Patients
• 17. Facial Medical-Aesthetic Treatments in Oncology Patients
• 18. Filler Materials: Indications, Contraindications, and Special Considerations in Oncology Patients
• 19. Aesthetic-Medical Treatments during the Disease: What Is the Plan?
• 20. The Role of the Aesthetic Doctor in Follow-Up of the Oncology Patient
• 21. Medico-Aesthetic Collaboration
• 22. Dietetics and Nutrition in Oncology Patients: Evaluation of Nutritional Status, Weight Control, and Nutrigenomics
• 23. Nutrition: Diet Therapy and Nutritional Supplements
• 24. Introduction to Vascular Complications in Oncology Patients
• 25. Anatomy of Lymphatic Drainage of the Limbs
• 26. Prevention and Treatment of Secondary Lymphedema of Extremities, Early Diagnosis of Lymphostasis, and Postsurgical Prevention and Conservative Treatment of Lymphedema
• 27. Prevention and Treatment of Venous Thromboembolism
• 28. Cosmetic-Medical Treatments
• 29. Micropigmentation Applied to Oncology Patients
• 30. Photoprotection in Oncology Patients
• 31. Scar Care after Surgical Treatment in Oncology Patients
• 32. Cancer and Physical Exercise
• 33. Ozone Therapy in Oncology Patients
• 34. Thermal Treatments in Postcancer Care
• Index