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Deodorant Ban in Radiotherapy Challenged


 

LOS ANGELES — A small pilot study at a community hospital in the Midwest challenges the common wisdom that breast cancer patients should shun aluminum-based deodorant when being treated with external radiation.

Radiation oncology nurses Juli Aistars and Kathleen Vehlow told 30 women to use their aluminum-based deodorants without regard to their scheduled treatments at Northwest Community Hospital in Arlington Heights, Ill.

The patients also applied a soothing 100% aloe vera gel from one to three times each day, with one application occurring within a half-hour of radiotherapy.

The researchers then used the Skin Toxicity Assessment Tool (Am. J. Clin. Oncol. 2004;27:626–31) to evaluate the patients' skin reactions twice each week during treatment and up to 6 weeks afterward.

Results were compared with those in 30 women who happened to be undergoing radiation treatments during the same time period and received the hospital's standard instruction: no aluminum-based deodorant on the treated side and no skin care products in the radiation field 4 hours before treatment.

The control group was younger—an average of 58 years vs. 64 years—but there was “no major clinical difference,” Ms. Aistars and Ms. Vehlow reported at the annual meeting of the American Society for Therapeutic Radiation and Oncology.

In both groups, the average time to onset of erythema was about 13 days, with a median of 12 days in the control group and 13 days in the experimental cohort.

The only patient to have no erythema was a woman allowed to use her personal deodorant at will.

Whereas slightly more experimental arm patients had faint, transient grade I erythema (17 patients vs. 15 in the control group), bright grade 2 erythema occurred more often in women told to eschew skin-care products (15 patients vs. 12 in the experimental group).

Common symptoms were not measured in the control group, but these women's charts showed similar reactions to those in the deodorant of choice group, according to the investigators. Among women allowed free use of their deodorants, the leading symptoms were itching (63%), tenderness (47%), pulling (30%), and burning (20%).

Aluminum-based deodorants usually are banned during treatment and other skin care products are likewise discouraged for fear that the metal content will increase the dose of radiation delivered to the skin.

The consequence if that were to happen—an increase in skin toxicity—not only can cause discomfort but also lead to interruptions to treatment in severe cases.

This common practice and the reasoning behind it are not supported by scientific evidence, according to the two investigators.

“It's one of those things handed down through the years that really hasn't changed,” Ms. Vehlow said in an interview at the poster session, where the data were presented.

Giving up the use of their customary personal deodorant temporarily can seem only a minor inconvenience for patients, she acknowledged, but it adds “one more burden in terms of body image” at a time when women are anxious and under “extreme stress.”

Indeed, when the women in the experimental group were surveyed at the conclusion of the experiment, 77% said they felt using their own deodorant was important.

Among the reasons given were “can't go to work without deodorant,” “social reasons,” and “it's the only one that works for me.”

Ms. Aistars and Ms. Vehlow urged further research with larger numbers of women and randomization at more than one site.

'It's one of those things handed down through the years that really hasn't changed.' MS. VEHLOW

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