Brighter days: Derm's skincare, therapy program lifts spirits of cancer patients

May 1, 2009

Brighter Days, a program launched by dermatologist Donald Richey, M.D., of Chico, Calif., adds a humanitarian touch to oncology treatment protocols. The program offers personalized skincare to help patients manage the side effects of chemotherapy and radiation, in a group therapy environment.

Key Points

"Life is good until the doctor tells you that you have cancer," Dr. Richey says.

"Cancer patients are scared to death. Hair loss and multiple cutaneous side effects make patients physically and emotionally uncomfortable.

Chemotherapy and radiation have extended and saved the lives of many cancer patients, but, according to Dr. Richey, such saving grace does not come without compromises. Common chemotherapy-induced side effects include alopecia, nail changes, photosensitivity, inflammation of actinic keratoses, and dry or xerotic skin, Dr. Richey says.

"Studies suggest that a positive mindset during treatment has a positive affect on outcomes. Cancer patients need someone to sit down and talk with them about what they're going through," he says.

"This program should be available to all cancer patients. There is no cost to the patient, and the physician need only spend the time."

Program's genesis

The program began seven years ago after Dr. Richey had watched a relative, Kris, struggle with side effects she experienced during 15 years of multiple chemotherapy treatments.

"I asked her in her last few days: 'If I could have made your skin feel better, and if I had been able to do things for your hair and nails, would that have been worth your while?' and she said, 'Yes,'" he says.

"The Brighter Days program was my promise to her," Dr. Richey tells Dermatology Times.

Dr. Richey says five oncology centers across the United States now offer the program.

"Talk, Touch, Tell" is the theme of Brighter Days. The "talk" part of a session begins with the distribution of baseball-style caps provided by the Life is Good company.

"Ninety percent of the attendees have lost their hair, and the hats are an immediate ice-breaker," Dr. Richey says.

"We continue the session by discussing the reasons for the physical side effects, specifically hair loss and dry skin and nails. This leads into a basic lecture on the differences among creams, lotions and ointments, and how they should be correctly applied," he says.

Dr. Richey also likes to mention the possibility of actual drug reactions to some newer agents, and he points out the potential flare of actinic keratoses in relation to 5-fluorouracil. He also recommends great emphasis be put on protecting the skin from sunlight.

Hair loss and the use of Rogaine (Johnson & Johnson) are also discussed.

Personal touch

The "touch" part of the program follows the lecture.

A nurse accompanies Dr. Richey as he designs a personalized skincare program. Each patient receives a bag of commercial-sized cleanser, moisturizer, sunblock and other products specific to his or her case.

"The thing that is really important is that they realize somebody cares about their comfort and appearance," Dr. Richey says.

The last part of the session - "tell" - is when patients open up and start sharing their stories and truly realizing they're not alone, and that other people have similar problems, he says.

"The skincare is very important, but the group therapy has been a very strong factor," Dr. Richey says.

The benefit of this part of the program is also obvious to the nurses who work with the doctor.

"Observing how the patients react gratefully to Dr. Richey's gentle touch and genuine concern for their skin is personally rewarding to me. Attendees are also able to network with other patients in various stages of their treatments, and talk about their illness to someone who is experiencing the same problems," says Imogean Alexander, medical assistant and supervisor for Dr. Richey.