Category Archives: Radiation Dermatitis

How To Protect Your Skin During Radiation Treatment for Breast Cancer

Image Source: freedigitalphotos.net / khunaspix Image Source: freedigitalphotos.net / khunaspix

How To Protect Your Skin During Radiation Treatment for Breast Cancer

I am frequently asked by those just about to begin radiation treatment for breast cancer what cream or lotion or ointment they can use to minimize the harsh effects of the radiation on their skin. That’s a great question and I’m always glad that they know this is important. I will answer it shortly.  First it’s important to know what the possible side effects of radiation are.

The Skin Problems You May Encounter With Radiation

Taking care of your skin during and after radiation treatment is really important.  Some of the skin changes that can be experienced during radiation treatment include redness, itching, dryness, swelling and peeling. In some extreme cases there can also be blistering (as with a sunburn), infections, fever and swelling – these symptoms should always be reported to your doctor.

Most of these effects do go away within weeks but sometimes people are left with long-term problems with their skin, such as fibrosis and/or pigmentation changes. For those who have had mastectomies, followed by radiation, followed by breast reconstruction with tissue expanders, there can be real problems.  If nothing is done to manage the side effects of the radiation therapy, the skin can often be quite damaged and this makes the tissue expanders and silicone implants used with breast reconstruction more difficult and uncomfortable because radiated skin can lose its elasticity and be tight and dry.

What NOT To Use

Some women are recommended to have a product such as Eucerin Aquaphor healing ointment.  Now I don’t wish to denigrate a company’s product but no one should be putting this stuff on their breast (or anywhere else for that matter).  Here is the list of ingredients:
Petrolatum, Mineral oil, Ceresin, Lanolin Alcohol, Panthenol, Glycerin, Bisabolol. These look pretty harmless unless you know something about these ingredients.

Petrolatum is a by-product of the petroleum industry, it’s full of xenoestrogens (environmental estrogens) that put us at a higher risk for breast cancer.  No way you should be using anything with petrolatum in the ingredients. Mineral oil is no better, It’s an extremely cheap and commonly used byproduct from crude oil and is a known xenoestrogen.  For more information on xenoestrogens, see my article Protect Yourself From Xenoestrogens and Estrogen Dominance.

Ceresin is a wax derived from ozocerite, a naturally occurring fossil wax found near soft shale. That sounds safe, right? Maybe not. This ingredient has been shown to cause skin irritation and sensitization in some people. You can check it out on the Environmental Working Group’s Skin Deep Database (reference below).

Lanolin is a wax obtained from the sebaceous gland of sheep. Years ago, lanolin was a good thing and has been used down through the centuries for moisturizing the skin and for softening leather. Sounds nice and natural, right? But there are hidden problems with lanolin. For one thing, lanolin is removed from sheepskin and wool with chemical scouring. Also, sheep are routinely dipped in pesticides and chemicals such as organochlorine, organophosphate, and pyrethroid to kill parasites. You can be sure that these toxic chemicals will concentrate in the lanolin – studies show that these chemicals bind to lanolin because of its waxy consistency and become concentrated in the lanolin. No way do you want to use anything with lanolin in it on your irradiated tissues.

Panthenol is derived from vitamin B-5. I have no problem with this ingredient, as far as I know, it is a safe ingredient.

Glycerin is chemically produced by combining water and fat, usually from vegetables, and while that sounds nice and natural (you can guess what’s coming!), these days it is generally made from GMO (genetically modified) vegetables such as corn and beets, and people are beginning to have problems with this. Sometimes glycerin is derived from the jatropha plant and back in 2012 the FDA sent out a notification that oils, glycerin, and proteins, if derived from the jatropha plant, may contain toxins. Glycerin actually draws moisture from the lower layers of the skin and holds it on the surface, thus drying the skin from the inside out and that won’t help you during radiotherapy.

Bisabolol is a plant-based chemical derived from certain essential oils. In this formulation it is probably not organically grown, so may be another source of toxic chemicals.

Parabens are chemical preservatives. Be sure not to use anything that contains propylparaben or methylparaben, these are usually the last ingredient in the list, they are associated with breast tumors. Prof Darbre at Reading University in the UK has been studying the effect of parabens on breast tissue for many years and has observed that 99% of human breast tissue samples collected contained parabens.  Her most recent research appears below. Parabens are causing major problems for our breast health.

You Have To Be A Label Reader!

All of this just shows why I teach that you MUST become a label reader when it comes to your body products and cosmetics.  You have to know what’s in them, otherwise you may just be putting yourself at risk for breast cancer (or risk of recurrence).

I am frequently asked for my recommendation on what to do about keeping skin healthy and protected against the burning experienced during radiotherapy so I am happy to share that here.  Although I chose not to have radiotherapy, a number of my coaching clients have used this protocol and it works wonderfully, includes no toxic chemicals nor (most importantly) anything that would hamper the radiotherapy process.

Avoid The Burned Boob!  Marnie’s Skin Protection Protocol During Radiotherapy Treatments

Two weeks prior to commencement of radiotherapy, follow this routine daily. Once radiotherapy commences, follow this routine twice per day, but making sure not to do this within an hour prior to radiotherapy appointment.

  1. Using a cotton pad soaked in organic calendula officinalis extract like this one, apply liberally to area to be irradiated.  It will soak in and should leave no residue that you need to wash off.
  2. Once that has soaked in, then apply a sufficient quantity of organic aloe vera gel (this is a good brand). Saturate tissue with this.
  3. Lastly, dilute 1-2 drops of a medicinal grade lavender essential oil (organic is best if you can get it) in one teaspoonful of organic coconut oil (this is a good brand) or organic hempseed oil (this is a great one) and apply that to the area.
  4. Repeat again at bedtime or the next morning, but not within one hour of the next radiotherapy session.

So to recap – two weeks prior to commencement of radiotherapy, you are following this protocol once per day. Once radiotherapy commences, you are using the calendula extract, the aloe vera gel, and the lavender oil mixed with coconut or hempseed oil twice per day (or more as your skin requires).  Continue this procedure on the weekends as well and continue doing this for a couple of weeks after the treatments end.  The difference between following this protocol and not doing it is quite stunning.

Why does it work so well?

The calendula extract helps to heal the skin and works better than the commonly prescribed remedies, and it has anti-cancer properties. The aloe vera gel is well known for its burn healing benefits, plus one study showed it may also assist radiotherapy to do its job better. The lavender oil helps to heal burns and wounds and has natural anti-inflammatory, antibacterial, pain relieving and anti-cancer properties. Coconut oil helps to heal burns and keeps the skin well nourished with its essential fatty acids. Hempseed oil has pain relieving, anti-inflammatory, anti-bacterial, anti-cancer, anti-fungal and neuroprotective properties.

Other tips – keep the area out of the sun while you are going through radiotherapy.  Wear loose fitting cotton or natural fiber clothing.  Avoid chlorine whenever you can, both in swimming pools and in shower water (use a good shower filter like these).

For more information on the healing effects of calendula, see my article The Benefits of Calendula Officinalis for Radiodermatitis.  Also learn how curcumin can help you at this time: Going Through Radiotherapy For Breast Cancer? Better Take Curcumin

References:

Relationship between everyday use cosmetics and female breast cancerhttp://www.ncbi.nlm.nih.gov/pubmed/24694726

Parabens can enable hallmarks and characteristics of cancer in human breast epithelial cells: a review of the literature with reference to new exposure data and regulatory status — http://www.ncbi.nlm.nih.gov/pubmed/25047802

Phase III Randomized Trial of Calendula Officinalis Compared with Trolamine for the Prevention of Acute Dermatitis During Irradiation for Breast Cancer – https://www.ncbi.nlm.nih.gov/pubmed/15084618

Anti-inflammatory, Anti-tumor-promoting, and Cytotoxic Activities of Constituents of Marigold (Calendula Officinalis) Flowers – https://www.ncbi.nlm.nih.gov/pubmed/17190444

Radio Sensitizing Effect of Aloe Polysaccharide on Pancreatic Cancer Bxpc-3 Cells – https://www.ncbi.nlm.nih.gov/pubmed/27393447

Burn Wound Healing Property of Cocos Nucifera: an Appraisal – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792613/

http://101healthsteps.com/2009/05/30/dangerous-chemical-glycerin-glycerine-glycerol-glycyl-alcohol/

http://www.ewg.org/skindeep/search.php?query=petrolatum

http://www.ewg.org/skindeep/ingredient/701212/CERESIN/

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The Benefits of Calendula Officinalis For Radiodermatitis

Image Source: freeimages.com / claudmey
Image Source: freeimages.com / claudmey

The Benefits of Calendula Officinalis For Radiodermatitis

I had an interesting exchange of emails this week with one of my subscribers who was asking me about the benefits of calendula for radiodermatitis (a/k/a the Burned Boob).

Because of my ongoing herbal studies, I am quite well acquainted with the herb calendula officinalis for many health complaints, chief amongst them being the healing of skin complaints like eczema, wound healing, insect bites, etc and it does this mainly through its antiseptic, anti-inflammatory and antibacterial properties.

Research on Calendula Officinalis and Radiodermatitis

I decided to see if there had been any recent research on calendula, I wanted to satisfy myself that it could be safely used as a healing agent after radiotherapy treatments so as to prevent the dreaded Burned Boob.

I found a very interesting 2004 study: Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of dermatitis during irradiation for breast cancer which indicated that calendula officinalis was highly effective for the prevention of acute dermatitis for postoperative patients undergoing radiation for breast cancer, better than the trolamine that was usually recommended.  The patients used a particular brand, Boiron, a French company, and it is widely available in many parts of the world.

I also found a 2013 study comparing calendula cream with another widely used aqueous cream called Essex: No differences between Calendula cream and aqueous cream in the prevention of acute radiation skin reactions–results from a randomised blinded trial.  This study, as can be gleaned from the title, found there was no difference between the effects of the calendula cream compared with Essex cream on patients undergoing radiotherapy.  That might be so, however, if you have a look at the ingredients for the Essex cream, it is full of petroleum products, which are known xenoestrogens (see my article Unraveling the Mystery of Xenoestrogens and Estrogen Dominance for more information on the hazards of xenoestrogens) and hormone disruptors, and put us at a higher risk for breast cancer.  Why anyone would recommend Essex cream to a woman who is undergoing treatments for breast cancer seems to me to be irresponsible.

To be fair, there were problems with a few of the ingredients in the Boiron cream as well – both Pegoxol-7 stearate and sodium hydroxide are moderate hazards, according to the Environmental Working Group website, Skin Deep.

Calendula Officinalis Has Anti-Tumor Properties

While scrolling through the list of research on the pubmed.gov website, I came across an interesting 2006 study that indicated calendula officinalis also has anti-tumor properties, as well as having a positive effect on lymphocytes, an important part of the immune system.  The study is titled A new extract of the plant Calendula officinalis produces a dual in vitro effect: cytotoxic anti-tumor activity and lymphocyte activation.  Please read it – I believe this to be important information for anyone going through breast cancer.

I do recommend the use of calendula officinalis for avoiding the Burned Boob.  I do believe, however, that the empowered patient must find a good organic calendula cream or gel and it should be used after each treatment (you might have to clear it with your radiologist however).

Here are a few good ones I found for you:

Weleda Calendula Healing Cream (available in the USA, UK and Australia)

Four Cow Farm Organic Calendula Remedy (Australian company)

Roseneath Organics Calendula Cream (Australian company)

Mukti Calendula Cream (Australian company) – this one also has the benefit of organic aloe vera in it, an especially good healing agent for radiodermatitis.

Lotioncrafter Certified Organic Calendula Extract (USA company, ships internationally)

I hope that helps you – and please contact me if you need any more information or assistance.

If you would like to receive my best tips on getting through breast cancer and preventing recurrences, just  sign up for my free e-newsletters and e-books on the right, and/or “like” me on Facebook (MarnieClark.com). I promise to do my utmost to keep you informed and empowered on your healing journey… and beyond. 

Unusual Help For Radiation Dermatitis

 

Photo courtesy of morgueFile / cohdra

Image Source: morgueFile / cohdra

Unusual Help For Radiation Dermatitis

Anyone who has gone through radiation therapy for breast cancer understands the meaning of the term “radiation dermatitis”.  By the time the treatment has ended, the patient can have a few nasty side effects ranging anywhere between a mild sunburn to severe and painful ulcerations of the skin.  Some unlucky patients even suffer from radiation necrosis, where the skin of the radiated area actually dies off, creating a hardened and painful area which can take quite some to heal properly.

I don’t share that with you to frighten you, but only to inform because if you are proactive you can definitely ease the discomfort and even hasten your healing time.

What Causes Radiation Dermatitis?

Radiotherapy, also known as radiation oncology, is a form of cancer treatment generally paired with chemotherapy and surgery.  The treatment consists of  beams of radiation being focused onto a tumor (or tumor site if it has been removed), the goal being to kill any malignant cells.  Because the radiation must first pass through the skin, the skin’s quickly dividing cells become damaged as a result.  Radiation dermatitis first presents as a patch of irritation resembling a sunburn. In most cases, healing occurs within weeks of the end of radiotherapy, though some patients report that the skin discoloration remains for many years.

As one radiation oncologist describes it, “Radiation causes skin to fail to reproduce properly, and thus as you ‘use up’ your normal skin, like we all do all day, there are no new layers of skin coming up from the bottom. So eventually the area can ulcerate. This might look like a thermal burn, but it has very little in common with a thermal burn, and the treatments for thermal burns will not help much.” (I’m sorry, I’ve lost the name of the doctor who shared this information.)

Dr Schor Shares Some Research on Bleach Baths for Radiation Dermatitis

Whenever I hear of some new tidbit of information about something assisting radiation dermatitis, I do try to share it.  This time, it comes from Denver-based naturopath, Jacob Schor, ND, FABNO (who is often quoted in this website).  Dr Schor shared this information in a newsletter dated January 14, 2014:

A study published in November 2013 suggests something rather peculiar, that exposure to very dilute laundry bleach may protect against radiation dermatitis.  If you’ve ever followed a cancer patient as they went through radiation treatment, you know what radiation dermatitis is.  Radiation damages the skin, causing what might be less euphemistically described as causing an industrial sunburn, or more accurately as producing human jerky.  Bleach may prevent this from happening, at least to some extent.

A dermatologist named Thomas Leung from Stanford University reported on a pair of trials bathing mice in diluted bleach (hypochlorite). Dilute bleach baths have been used for years to treat eczema, without anyone really knowing why they helped.

One theory was that bleach, being antimicrobial, killed off bacteria that were causing the eczema. A 2009 paper by Amy Paller et al suggests that bleach baths are effective at lowering Staph aureus populations on the skin.[1]    While this sounds like a plausible explanation, there is debate and many consider the bleach dilutions used too weak to have any antibacterial effect.

Really dilute bleach is used to treat eczema, 0.005% sodium hypochlorite, or about one part laundry bleach to 1000 parts water. Leung offers a different explanation for the benefit of bleach.  His research group first examined how diluted bleach affects inflammation; eczema is after all inflammation.

The researchers first examined the effect bleach has on Nuclear factor-kappaB (NF-kB ).  This signaling protein triggers the recruitment of inflammatory cells to sites of infection. Leung’s team exposed human skin cells to the bleach dilution used to treat eczema for an hour and found it blocked NF-kB signaling. The bleach oxidizes the molecule responsible for activating NF-kB and so stops the inflammatory cascade from being initiated. By blocking this activator, the bleach inhibits the NF-kB inflammatory pathway.

This is ever so interesting and opens multiple possibilities.  NF-kB is kind of the common denominator of most inflammatory reactions; it ‘regulates cellular responses to inflammation and aging, and alterations in NF-kB signaling underlie the pathogenesis of multiple human diseases.’

Leung’s team tried dilute bleach on mice to see if it changed radiation dermatitis, as this reaction is instigated by NF-kB. They also tried bleach on the ageing skin of healthy but old mice.

In the radiation experiment, the mice were placed in either a dilute bleach bath or a water bath for 30 minutes daily for ten days prior to radiation treatment. The radiation burns on these ‘bleached’ mice were milder and healed faster than those on the mice who had only been exposed to water baths.

Similar benefits were seen in the old mice.  Daily bleach baths ‘… increased skin cell production resulting in thicker, younger-looking skin than old mice that took plain water baths. In addition, they had lower expression of two genes classically associated with aging.  The effect was short lived, however. The rejuvenated skin returned to its elderly look after about two weeks because the action of bleach on NF-kB is mild, and diminishes with time.’ [2,3]

This might be a surprisingly simple way to reduce radiation dermatitis.  Nasty skin reactions can force postponement of radiation treatment and reduce its effectiveness at preventing cancer recurrence.  Preventing the skin reactions might improve long-term survival.

Bleach may do more than prevent these skin reactions in cancer patients.  NF-kB  ‘plays a critical role in cancer development and progression’ and is a ‘key pathway in activation of immune responses’ and this ‘activation may also affect the cancer’s response to therapy, making it less susceptive to radio and chemo treatment.’ [4]

We already encourage cancer patients to take many of the supplements that lower NF-kB .  These include green tea [5] , curcumin [6,7], quercetin [8-10], nigella sativa, [11] resveratrol  and other polyphenols [12].  A daily dip in the bleach might help cancer patients in other ways.

This study draws my attention because it is so counterintuitive.  It is backwards from what you would think.  Bleach is a nasty caustic oxidant. It should hurt, not help.

One way to understand this is to see this as an example of hormesis. In toxicology, hormesis refers to the phenomenon in which a graph of a substance’s toxic effects takes on a j-shaped or u-shaped curve.    Low doses can sometimes produce the opposite effect of higher doses.  It is like homeopathy’s Law of Similars, just skip the infinitesimal dilutions where there is nothing left except good vibrations..   Concentrated bleach will burn the dickens out of your skin, but in tiny amounts, bleach will protect and heal the skin.

Understanding hormesis may be key to our understanding other therapies we employ in naturopathy.  Many of the phytochemicals we value so much are toxins produced by plants for self-protection.  Curcumin, resveratrol, quercetin and other  of our valued phytochemicals are actually insecticides, anti-fungals and neurotoxins.  Plants make them to ward off predators and kill infectious microbes.  When we use them, it is for their hormetic action.  Exposure triggers an adaptive response in the body recruiting resources to neutralize potential injury.

So what exactly is a 0.005% hypochlorite bleach solution?  Generic bleach is typically about 3-6% sodium hypochlorite.  To reach this dilution one would dilute one-part bleach with about 1,000 parts water.  An average bathtub contains about 100 liters of water, more or less, so a tenth of a liter or 100 ml of bleach, (3.4 oz or about half a cup) would produce approximately this dilution.  Of course bathtubs vary greatly in size, but this gives you an approximate idea.

This is close to the dilution that various websites suggest to treat eczema. The National Eczema Association[13]  and the American Academy of Allergy, Asthma and Immunology both suggest ¼ to ½ cup. [14]

While these data come from animal experiments, there seems to be little risk in translating them into treatment protocols for people.  As mentioned bleach baths are already used to treat eczema.  It seems easy enough to incorporate them into a treatment for cancer patients as well.

References:

1. Huang JT, Abrams M, Tlougan B, Rademaker A, Paller AS. Treatment of Staphylococcus aureus colonization in atopic dermatitis decreases disease severity. Pediatrics. 2009 May;123(5):e808-14. doi: 10.1542/peds.2008-2217.

2.   Alyssa Botelho. Vastly diluted bleach may have protective effect on skin. New Scientist:18:28 15 November 2013.

3.  Leung TH, Zhang LF, Wang J, Ning S, Knox SJ, Kim SK. Topical hypochlorite ameliorates NF-κB-mediated skin diseases in mice. J Clin Invest. 2013 Dec 2;123(12):5361-70. Full text: 10.1172/JCI70895

4.  Berkovich L, Ron I, Earon G, Abu-Ghanem S, Rimmon A, Lev-Ari S. [The role of medicinal herbs with anti-inflammatory properties in prevention and treatment of cancer].[Article in Hebrew] Harefuah. 2012 Nov;151(11):629-32, 654.

 5. Syed DN, Afaq F, Kweon MH, Hadi N, Bhatia N, Spiegelman VS, Mukhtar H. Green tea polyphenol EGCG suppresses cigarette smoke condensate-induced NF-kappaB activation in normal human bronchial epithelial cells. Oncogene. 2007 Feb 1;26(5):673-82.

6.  Meng Z, Yan C, Deng Q, Gao DF, Niu XL. Curcumin inhibits LPS-induced inflammation in rat vascular smooth muscle cells in vitro via ROS-relative TLR4-MAPK/NF-κB pathways. Acta Pharmacol Sin. 2013 May 6.

7.  Capini C, Jaturanpinyo M, Chang HI, Mutalik S, McNally A, Street S, Steptoe R, et al. Antigen-specific suppression of inflammatory arthritis using liposomes. J Immunol. 2009 Mar 15;182(6):3556-65

8.  Weng Z, Zhang B, Asadi S, Sismanopoulos N, Butcher A, Fu X, Katsarou-Katsari A, et al. Quercetin is more effective than cromolyn in blocking human mast cell cytokine release and inhibits contact dermatitis and photosensitivity in humans. PLoS One. 2012;7(3):e33805.

9.  Yin Y, Li W, Son YO, Sun L, Lu J, Kim D, Wang X, et al.  Quercitin protects skin from UVB-induced oxidative damage. Toxicol Appl Pharmacol. 2013 Jun 1;269(2):89-99.

10.  Byun EB, Yang MS, Choi HG, Sung NY, Song DS, Sin SJ, Byun EH. Quercetin negatively regulates TLR4 signaling induced by lipopolysaccharide through Tollip expression. Biochem Biophys Res Commun. 2013 Feb 22;431(4):698-705. doi: 10.1016/j.bbrc.2013.01.056.

11.  Vaillancourt F, Silva P, Shi Q, Fahmi H, Fernandes JC, Benderdour M.J. Elucidation of molecular mechanisms underlying the protective effects of thymoquinone against rheumatoid arthritis.
Cell Biochem. 2011 Jan;112(1):107-17. doi: 10.1002/jcb.22884.

 12. Zhu X, Liu Q, Wang M, Liang M, Yang X, Xu X, Zou H, Qiu J. Activation of Sirt1 by resveratrol inhibits TNF-α induced inflammation in fibroblasts. PLoS One. 2011;6(11):e27081. doi: 10.1371/journal.pone.0027081.

13.  http://nationaleczema.org/eczema/treatment/alternative-therapies/bleach-baths/

14.  http://www.aaaai.org/conditions-and-treatments/library/allergy-library/bleach-bath-recipe-for-skin-conditions.aspx

A big thank you to Dr Schor for allowing me to share his newsletter with all of you.  I particularly enjoyed his description of why he thought bleach might work, as well as the protective supplements that he recommends to help radiation patients.

One More Recommendation

I frequently get asked for natural topical products that help with the discomfort of radiation dermatitis and my followers and clients have had very good results with one particular organic body cream so I like to share it whenever anyone mentions they are about to have radiation treatments.  Despite what the radiation oncologist said earlier in this article, there are things that help quite significantly by protecting the skin and helping it to heal much quicker.

UPDATE: See my page How To Protect Your Skin During Radiation Treatment for Breast Cancer

If you would like my help with getting through breast cancer in an inspiring and ultra-healthy way, please sign up for my free e-newsletters and e-book on the right, and/or “like” me on Facebook (Marnie Clark, Breast Health Coach).  It is my honor and my goal to help you through this so that you emerge from breast cancer feeling better than before, thriving!