How metastatic breast cancer changes your nails and skin

With metastaticinfo-icon breast cancer, you may have nail and skin changes that result from certain treatments. Because of prolonged and ongoing treatment, you are at higher risk for nail and skin side effects, which may develop slowly over time. For example

  • Ongoing chemotherapyinfo-icon for metastatic disease or for bone metastasisinfo-icon can cause neutropeniainfo-icon, a low blood cell countinfo-icon. This increases your risk for infections of the skin and nails.
  • Chemotherapy can make finger- and toenails discolored, painful and cracked or cause them to fall off. Your skin may become sensitive and dry.
  • Radiationinfo-icon can burn the skin on or around the treatment area.
  • Certain targeted therapies can cause rashes and changes to your finger- and toenails .

What You Can Do About Nail and Skin Changes

Your providers are your partners. Let them know about any nail and skin side effects you noticed since starting a treatment:

  • Record how long you have had symptoms. What words would you use to describe them?
  • Rate your discomfort on a scale of 1 (not uncomfortable) to 10 (the most uncomfortable you have ever been).
  • Be as specific as you can. How much do the side effects impact your life?

Get medical help immediately if you develop severe itching or rash during treatment, as these may be signs of an allergic reaction.

Sometimes when a treatment causes nail and skin side effects, your doctor may be able to prescribe medicineinfo-icon to treat it. Make sure to use all medicines as directed, even when the symptoms improve, so the side effectinfo-icon won’t worsen again.

When nail and skin side effects are severe, especially if they affect your quality of lifeinfo-icon or cause pain that makes it hard to keep up with your usual daily activities, your doctor may be able to lower the doseinfo-icon of the medicines causing the side effect. 

If you have been on a medicine for a long time, sometimes adding extra time to the “week off” of a cycle, or changing how the cycle is given, can reduce symptoms and allow your treatment to continue. Your doctor may also stop treatment for a time, or switch you to another treatment to keep your symptoms from getting worse.

It’s possible the medicine could work as well against the breast cancer at a lower dose or on a less frequent schedule. Talk with your providers about how they will monitor the impact of any changes to your treatment.

Sometimes people don’t want to report side effects because they are worried that if the dose or timing of the medicine changes, the treatment will not be as effective. But most treatments have recommendations built-in to lower the dose or change the timing of the medicine if symptoms are of concern. Studies show that even if the dose is lowered or changed, the treatment will still work as well against the cancer. If the dose or change would not be effective, your healthcare providers would then change you to a different treatment.

Although one goal of your treatment is to keep the cancer under control for as long as possible, a second, equally important goal is to allow you to live a good life. Remember, your needs are an important part of your treatment plan. Open communication with your providers is very important. You and your providers will decide together whether continuing with a certain treatment is right for you.

August 14, 2019