Management of hand-foot syndrome in patients treated with ...

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completed at clinic visits. These materials should
incorporate:
1. Instructions on dosing, including how many
tablets to take with each dose and information
on the timing and importance of fluid intake
with medication.
2. A diary or calendar to track dosing and side
effects.
3. Reminders stressing the importance of calling
promptly and interrupting treatment at the first
signs of grade 2 toxicity.
4. Contact numbers for oncology nurses and physicians.
These materials should be accompanied by
weekly follow-up phone calls for the first few
weeks of therapy to ensure that patients fully
understand their role in reporting side effects and
withholding therapy, as instructed.
In conclusion, the nurses’ role in managing HFS in
capecitabine-treated patients is pivotal for both its
prevention and palliation.
References
Abushullaih, S., Saad, E.D., Munsell, M., Hoff, P.M., 2002.
Incidence and severity of HFS in colorectal cancer patients
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Cancer Investigation 20 (1), 3–10.
ARTICLE IN PRESS
Table 4 Summary of preventative and management techniques for HFS.
Y. Lassere, P. Hoff
1 Ensure patient is able to recognise HFS (and other adverse events) by education and use of written
information available from the manufacturer or otherwise.
2 Recommend preventative emollient use (e.g. hand cream).
3 Ensure that the patient follows dose interruption/reduction guidelines carefully, which apply to all
adverse events. Make sure the patient understands the importance of this prior to starting treatment
and has written information available from the manufacturer or otherwise.
4 Ensure the patient has telephone access to a key person, e.g. oncology nurse, during office hours in the
event of need to answer questions or concerns.
5 Follow up with the patient (by phone) to determine the outcome of HFS and provide other supportive
advice.
6 Reassure the patient that there are no permanent complications once adverse events have resolved.
7 Advise patients to use topical emollients and creams to keep the skin moist.
8 Recommend patients to avoid extremes in temperature, pressure, and friction of skin.
9 Mention that relief can be achieved by submerging hands and feet in cool water.
10 Suggest cushioning sore skin with soft pads or socks and keeping the skin exposed to air whenever
possible to prevent excess sweating.
11 Refer patients to a dermatologist if blistering or ulceration occurs.
12 As a last resort, if treatment is of benefit, change the dosing regimen.
13 Discontinue treatment if HFS is severe and unresolved by dose interruption/reduction.
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