By Nicole LeBoeuf, MD, MPH, clinical director of Dana-Farber’s Center for Cutaneous Oncology
While many people know that traditional chemotherapy drugs can increase sensitivity to the sun, some of the newer targeted therapies do as well. In fact, the risk of sun-related skin damage may be even higher with certain targeted drugs than with chemotherapy agents. One example is targeted therapies for melanoma, lung cancer, and other malignancies that work by targeting mutations in the genes BRAF and EGFR. The skin damage associated with such treatments can be triggered by exposure to ultraviolet A (UVA) rays in sunlight, which penetrate window glass.
Immunotherapies, which attack cancer by activating the immune system, can also trigger skin rashes as a result of sun exposure. While we don’t know exactly how some of these drugs cause sun reactions, the safest thing is for patients to protect themselves.
As a general rule, we recommend against sunbathing without sun protection for all of our patients – even those who are not on chemotherapy – because of the risks of skin cancer.
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That said, we recommend that patients continue to do the things that bring them joy and relaxation while they are undergoing treatment. If you enjoy being outdoors in the summer, you should continue to do so! But when possible, avoid direct sun exposure mid-day (between 10 a.m. and 2 p.m.). We recommend using sun-protective clothing, hats, and sunglasses, and applying sunscreen regularly to their exposed skin (scalp, face, neck, arms, etc.). High SPF, broad-spectrum agents best block both UVA and UVB rays and should be applied daily – and reapplied every 2 hours if you are spending prolonged periods outdoors – and after swimming or sweating heavily. Remember, since targeted agents increase UVA sensitivity, reactions can occur indoors or in a car. Zinc oxide and titanium dioxide based products are great, safe choices.
While these lifestyle modifications are new for many patients, we remind them that they can enjoy the summer.