August marks the beginning of those “dog days of summer.” It also is a time when we need to be extra vigilant about protection from the sun. For GIST patients, this is especially important, since some of the possible side effects of Gleevec include skin issues such as rashes, heat sensitivity and dry skin. Side effects that may impact the skin for Sutent and Stivarga are similar to those for Gleevec, and may include rash or dry skin (Sutent and Stivarga) or redness, swelling or pain of the skin (Stivarga). GIST patients report that Gleevec and similar drugs also seem to increase the sensitivity to the sun, increasing the possibility of sunburn.

Most of the time these issues are mild and self-limiting, but sometimes they require adding a dermatologist to your treatment team.

The Life Raft Group’s website provides a comprehensive list of the side effects related to Gleevec, and suggested courses of treatment for them.

As wonderful as the sun feels, especially after the harsh winter many of us experienced, its effects are cause for concern, especially for patients already challenged with skin issues. Keep reading to learn some helpful skin protection tips for GIST patients.

According to the Skin Cancer Foundation’s Guide to Sunscreen:

“The US government has officially identified ultraviolet radiation (UVR) both from the sun and from tanning machines as a known cause of cancer in humans. UVR produces DNA damage that may lead to mutations (abnormalities) in genes involved in the development of skin cancer. Therefore, along with other sun safety strategies, sunscreens that absorb or block UVR serve an important protective function. “

The US Environmental Protection Agency (EPA) estimates that the sun causes 90 percent of all nonmelanoma skin cancers, and other research links it to 65 percent of all melanomas. Each year, an estimated 3.5 million or more new cases occur in the US of the nonmelanoma skin cancers basal and squamous cell carcinoma (BCC and SCC). An estimated 76,250 new cases of invasive melanoma, the most dangerous form of skin cancer, will be diagnosed in the US in 2012, with nearly 9,180 resulting in death, according to the American Cancer Society.

Photoaging, or UV-induced skin aging, is another long-term result of sun exposure. While not threatening to life, it is threatening to the quality of life. Excessive unprotected time in the sun leads to premature wrinkling, sagging, a leathery texture and hyperpigmentation (so-called “aging spots” or “liver spots” that are really the result of sun damage).

Sunburn, the most immediate, obvious example of UVR damage, results from sun-induced inflammation and/or blistering of the skin. When immune cells called mast cells race to the injured skin site in response to the damage, they dilate the blood vessels and produce erythema (reddening), edema (swelling), and burning and stinging sensations as part of the healing process. This DNA damage can be the first step towards skin cancer. Intermittent, intense UVR exposure, often producing sunburn, is believed to be more closely associated with melanoma than is chronic sun exposure. One blistering sunburn in childhood or adolescence doubles the risk of melanoma later in life; five sunburns by any age doubles the risk as well. UVR also weakens immune surveillance mechanisms, allowing tumor cells to proliferate more freely. This effect adds to the immune suppression induced by other causes, including cancer chemotherapy and antirejection drugs for transplants.” (Henry W. Lim, MD and Steven Q. Wang MD, members of the Skin Cancer Foundation’s Photobiology Committee)

Here are some skin protection tips for GIST patients

The best way to avoid sunburn or a photo- sensitive reaction is to avoid sun exposure, but for those of us who love the outdoors that isn’t an acceptable option. The sun is strongest between 10 am and 4 pm, so if you must be outdoors during these times, try to avoid being in the direct sun. Seek a shady spot. Covering up will help shield your skin from the sun. Look for a hat with at least a four inch brim to keep your head, ears and neck protected, and wear sunglasses with UV protection.

Consult with your dermatologist or GIST specialist to decide which sunblock is right for you, taking into consideration your individual side effects and skin issues. As a general rule, use a sunblock with an SPF rating of at least 30, and one that provides both UVA and UVB protection. These are also referred to as “broad spectrum” sunblocks.  Choose a sunblock that has tested the best in UVA and UVB protection, has low toxicity and remains stable in the sun.

Utilizing the strategies provided for you by your treatment specialists and by adopting some common sense best practices, you can enjoy the rest of the summer with greater confidence that  you are protecting your skin and are practicing good self-care.

Mary Garland
Author: Mary Garland