Symptoms, Causes, and Remedies of Hand-Foot Syndrome
In the realm of cancer treatment, certain chemotherapy and targeted therapy drugs can lead to a condition known as Hand-Foot Syndrome (HFS). This syndrome is characterised by symptoms such as painful redness, swelling, blistering, and peeling of the skin on the palms and soles.
Among the chemotherapy drugs that are well-established as HFS inducers are capecitabine and liposomal doxorubicin, including pegylated liposomal doxorubicin, as well as 5-fluorouracil (5-FU) and cytarabine [1][3].
While targeted therapy drugs do not directly list specific agents causing HFS in the search results, tyrosine kinase inhibitors (TKIs) such as pazopanib, lapatinib, and sunitinib are mentioned as oral targeted therapies with notable side effects [5]. However, in clinical practice, sorafenib and sunitinib are known to be associated with HFS, even though the sources focus more on hepatotoxicity.
For those experiencing HFS, natural remedies and management techniques include applying ice packs, elevating the hands or feet, wearing loose shoes, avoiding harsh chemicals, and gently patting the skin dry. Silymarin, a compound from milk thistle, may also help reduce HFS symptoms when applied as a 1% strength gel to the feet twice daily for 9 weeks [2].
It is crucial to speak with a doctor if someone is struggling with HFS symptoms, if a child develops swollen hands or feet, or if one is about to begin chemotherapy and wants to understand the risk of developing HFS based on the type of drug they will receive. HFS is not permanent and will usually heal once treatment finishes for chemotherapy-induced HFS, while symptoms for sickle cell disease-induced HFS will typically last for a while before easing on their own.
In severe cases, people may experience cracked, flaky, or peeling skin, blisters or sores, severe pain, and difficulty using their hands or feet. HFS most often develops between 2 days to 3 weeks after someone starts chemotherapy treatment.
The symptoms of HFS are categorised into four grades based on their severity: grade 1 (abnormal sensations or tingling in the hands and feet), grade 2 (painless swelling or redness, and discomfort when walking or holding objects), grade 3 (inflammation and painful swelling in the palms of the hands, soles of the feet, and around toenails and fingernails), and grade 4 (ulceration, scaling of the skin, severe pain, and blistering) [4].
HFS occurs due to small amounts of chemotherapy medication leaking out of the capillaries. Treatment for HFS caused by chemotherapy includes over-the-counter pain medications, urea cream, steroid medications, and altering the chemotherapy dosage or schedule. For people with sickle cell disease, treatment for HFS consists of pain medication and drinking plenty of fluids.
References:
[1] National Cancer Institute. (2021). Hand-Foot Syndrome. https://www.cancer.gov/about-cancer/treatment/side-effects/skin/hand-foot-syndrome [2] National Center for Complementary and Integrative Health. (2021). Silymarin. https://www.nccih.nih.gov/health/silymarin [3] American Cancer Society. (2021). Chemotherapy and Hand-Foot Syndrome. https://www.cancer.org/treatment/understanding-your-diagnosis/treatment-side-effects/skin-changes/hand-foot-syndrome.html [4] American Society of Clinical Oncology. (2021). Hand-Foot Syndrome. https://www.cancer.net/navigating-cancer-care/side-effects/skin-changes/hand-foot-syndrome [5] National Comprehensive Cancer Network. (2021). Tyrosine Kinase Inhibitors. https://www.nccn.org/professionals/physician_gls/default.aspx?ft=5&f=2021&Category=Breast+Cancer&C=Breast+Cancer&S=Treatment&P=Treatment
- Sickle cell anemia, a genetic blood disorder, can sometimes cause symptoms similar to Hand-Foot Syndrome (HFS), although the exact causes and treatments may differ.
- Science continues to explore various medical conditions and their interactions with health-and-wellness practices, such as exploring the potential of milk thistle's active compound silymarin in reducing HFS symptoms.
- Skin care becomes increasingly crucial during chemotherapy, as certain drugs can lead to HFS, a condition characterized by redness, swelling, blistering, and peeling on the palms and soles.
- Proper management is vital for people experiencing HFS, a condition that can affect various aspects of health and wellness, including seeking medical advice for symptoms, applying ice packs, and avoiding harsh chemicals on the affected skin.
