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Information from PDQ for Patients
Pruritus
208/00609
** INTRODUCTION **
This patient summary on pruritus is adapted from a summary written for health
professionals by cancer experts. This and other credible information about
cancer treatment, screening, prevention, supportive care, and ongoing clinical
trials is available from the National Cancer Institute. Pruritus (itching) is
a side effect of some cancer therapies and may be a symptom of some types of
cancers. This brief summary describes pruritus, its causes and treatment.
** OVERVIEW **
Pruritus is an itching sensation that triggers the desire to scratch. It is a
distressing symptom that can cause discomfort. Scratching may cause breaks in
the skin that may result in infection. Pruritus can be related to anything
from dry skin to undiagnosed cancer. It can occur in people who have cancer or
in those who have received cancer treatment.
** RISK FACTORS **
Pruritus may occur in some people with cancer but not in others. However, the
following persons with cancer may be at a higher risk for developing pruritus:
- Persons with various malignant diseases that are known to produce
symptoms of pruritus, including, but not limited to AIDS-related
Kaposi's sarcoma, Hodgkin's disease and other lymphomas, leukemias,
adenocarcinomas, and cancer of the stomach, pancreas, lung, colon,
brain, breast, and prostate. Pruritus tends to disappear when cancer
is cured or in remission. It may reappear when the disease recurs.
- Persons who have had chemotherapy. Usually the itching subsides within
30-90 minutes and does not require treatment. The development of
pruritus may be a sign that the patient is especially sensitive to the
chemotherapy drug.
- Persons who have had radiation therapy. Radiation can kill skin cells
and cause burning and itching. As the skin peels off, scratching can
damage it further, which creates the potential for infection.
Treatment may need to be interrupted to allow the skin time to heal.
- Persons who have had radiation therapy plus chemotherapy. The combined
effects of these drugs can cause an increased skin reaction.
- Persons who have had biological response modifier therapy (a treatment
to try to improve the body's natural immune response to disease).
- Persons who have had bone marrow transplantation. Patients may
experience changes in skin condition that include dryness, itching, and
rashes.
Drugs given at any time during cancer treatment may cause pruritus. Itching
may be caused by sensitivity to the drug, or the drug may interfere with normal
nerve function.
Pruritus can be a symptom of infection. The infection may or may not be
related to cancer treatment. Infections involving itching may be caused by a
tumor, fungus, discharge from a wound, or drainage after surgery.
Pruritus is a symptom, not a diagnosis or disease. If you feel itching, let
your doctor know. The doctor will ask for your medical history and give you a
thorough physical examination. This assessment will enable the doctor to
discover the problem that is causing the itching and find the best treatment
for it.
** TREATMENT **
Maintaining healthy skin may relieve pruritus. Good skin care includes
adequate nutrition and daily fluid intake, protection from the environment, and
cleansing practices that don't dry the skin.
Some specific factors that may relieve itching are the following:
- Moisturizing creams and lotions. These water-containing products form
films over the skin surface and encourage the production of moisture
beneath the film. This prevents dryness, which can cause itching.
These products should be carefully chosen for each person's needs.
Some ingredients, such as petrolatum, lanolin, and mineral oil can
cause allergic reactions in some people.
- Powders, bubble baths, and cornstarch. These products should be used
with caution because they can irritate the skin and cause itching.
Cornstarch is an effective treatment for itching that is associated
with dry skin due to radiation therapy but should not be applied to
moist surfaces, to areas with hair, sweat glands, skin folds, or to
areas close to mucosal surfaces, such as the vagina or rectum. When
cornstarch becomes moist, it can promote fungal growth. Some powders
such as those that contain talcum and aluminum can cause skin
irritation during radiation therapy and should be avoided when you are
receiving radiation treatment. Alcohol or menthol, which are found in
some creams and over-the-counter lotions, may also produce skin
reactions. Topical steroid creams may reduce itching but may cause
thinning of the skin and can make it more prone to injury.
- Tepid baths. Baths that are moderately warm and last no longer than
one half hour every day or every two days can help relieve itching.
Frequent bathing can aggravate dry skin, and hot baths can promote
itching.
- Mild soaps. Mild soaps contain less soap or detergent that can
irritate skin. Oil can be added to the water at the end of a bath or
applied to the skin before drying.
- A cool humid environment. Heat can cause itching. Your skin loses
moisture when the humidity is low. A cool, humid environment may
prevent your skin from itching.
- Removal of detergent residue. Residue left on clothing by detergent
and fabric softeners may aggravate pruritus. The irritation can be
reduced by adding vinegar (one teaspoon per quart of water) to the
laundry rinse cycle or by using a mild laundry soap that is sold for
washing baby clothes.
- Cotton clothing and bed sheets. Body heat, wool, and some synthetic
fabrics can aggravate itching. It may be helpful to wear
loose-fitting, lightweight cotton clothing and to use cotton bed sheets.
In addition to the skin-care factors, medications applied to the skin or taken
by mouth may be necessary to treat pruritus. Antibiotics may relieve itching
caused by infection. Antihistamines may be useful in some cases of pruritus.
Sedatives, tranquilizers, and antidepressants may be useful treatments.
Aspirin seems to have reduced itching in some patients but increases it for
others. Aspirin combined with cimetidine may be effective for patients with
Hodgkin's disease or polycythemia vera.
Interrupting the itch-scratch-itch cycle, an increase in itching that can
result from the process of scratching, may also help to alleviate pruritus.
The cycle may be broken by applying a cool washcloth or ice over the affected
area. Rubbing the skin and applying pressure or vibration to the skin may also
help. Other methods that may be useful in relieving symptoms include
distraction, music therapy, relaxation, and imagery techniques.
** TO LEARN MORE **
Call
For more information, U.S. residents may call the National Cancer Institute's
(NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237)
Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing
callers with TTY equipment may call 1-800-332-8615. The call is free and a
trained Cancer Information Specialist is available to answer your questions.
Web sites and Organizations
The NCI's Cancer.gov Web site (http://cancer.gov) provides online access to
information on cancer, clinical trials, and other Web sites and organizations
that offer support and resources for cancer patients and their families. There
are also many other places where people can get materials and information about
cancer treatment and services. Local hospitals may have information on local
and regional agencies that offer information about finances, getting to and
from treatment, receiving care at home, and dealing with problems associated
with cancer treatment.
Publications
The NCI has booklets and other materials for patients, health professionals,
and the public. These publications discuss types of cancer, methods of cancer
treatment, coping with cancer, and clinical trials. Some publications provide
information on tests for cancer, cancer causes and prevention, cancer
statistics, and NCI research activities. NCI materials on these and other
topics may be ordered online or printed directly from the NCI Publications
Locator (http://cissecure.nci.nih.gov/ncipubs). These materials can also be
ordered by telephone from the Cancer Information Service toll-free at
1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
LiveHelp
The NCI's LiveHelp service, a program available on several of the Institute's
Web sites, provides Internet users with the ability to chat online with an
Information Specialist. The service is available from 9:00 a.m. to 7:30 p.m.
Eastern time, Monday through Friday. Information Specialists can help Internet
users find information on NCI Web sites and answer questions about cancer.
Write
For more information from the NCI, please write to this address:
National Cancer Institute
Office of Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580
** ABOUT PDQ **
PDQ is a comprehensive cancer database available on Cancer.gov.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information
database. Most of the information contained in PDQ is available online at
Cancer.gov (http://cancer.gov), the NCI's Web site. PDQ is provided as a
service of the NCI. The NCI is part of the National Institutes of Health, the
federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on
cancer prevention, detection, genetics, treatment, supportive care, and
complementary and alternative medicine. Most summaries are available in two
versions. The health professional versions provide detailed information
written in technical language. The patient versions are written in
easy-to-understand, non-technical language. Both versions provide current and
accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and
reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are
responsible for writing and maintaining the cancer information summaries. The
summaries are reviewed regularly and changes are made as new information
becomes available. The date on each summary ("Date Last Modified") indicates
the time of the most recent change.
PDQ also contains information on clinical trials.
Some patients have symptoms caused by cancer treatment or by the cancer itself.
Patients who have symptoms related to cancer treatment may want to take part in
a clinical trial. A clinical trial is a study to answer a scientific question,
such as whether one method of treating symptoms is better than another. Trials
are based on past studies and what has been learned in the laboratory. Each
trial answers certain scientific questions in order to find new and better ways
to help cancer patients. During supportive care clinical trials, information
is collected about new treatment methods, the risks involved, and how well they
do or do not work. If a clinical trial shows that a new treatment is better
than one currently being used, the new treatment may become "standard."
Listings of clinical trials are included in PDQ and are available online at
Cancer.gov (http://cancer.gov/clinical_trials). Descriptions of the trials are
available in health professional and patient versions. Many cancer doctors who
take part in clinical trials are also listed in PDQ. For more information,
call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at
1-800-332-8615.
Date Last Modified: 06/2002
******************************************************************************
* If you want to know more about cancer and how it is treated, or if you *
* if you wish to know about clinical trials for your type of cancer, you *
* can call the NCI's Cancer Information Service at 1-800-422-6237, toll *
* free. A trained information specialist can talk with you and answer *
* your questions. *
******************************************************************************
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This information has been brought to you by
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