As you may know, more and more patients are diagnosed with breast cancer and most (approx. 80%) are treated with radiotherapy. Radiotherapy is very effective and has dramatically improved breast cancer prognosis. The overall mortality linked to this terrible disease is now fortunately reduced to below 20%. However, about ten years post-radiotherapy, up to 30% of patients develop a form of chronic skin disease directly related to the radiotherapy referred to as chronic radiation dermatitis. One of the hallmarks of this dermatitis is the presence of numerous telangiectasias (dilated red blood vessels). Furthermore, this skin disease is often marked by an abnormal pigment distribution with areas of lack of pigment in combination with areas of too much pigment (dyspigmentation), very thin and fragile skin (skin atrophy), and sometimes an induration of the skin (subcutaneous fibrosis). Over time, even ulcerations and secondary skin carcinoma of the affected skin may develop.

Paradoxically, treating cancer and improving prognosis lead to an increase in the number of people affected by chronic radiation dermatitis. In France alone, there are probably more than 10,000 patients newly affected by this condition every year. Those patients, who have won the fight against cancer, have unfortunately a rather high likelihood of developing chronic radiation dermatitis down the line. A decrease in the quality of life of those patients appears to be obvious but can’t be stressed enough.

Fortunately, treatment with vascular laser has proved to be safe and highly effective in treating the chronic radiation dermatitis. It has also been shown to greatly improve quality of life. As an example of positive outcomes, a study conducted in France demonstrated in more than 100 women the efficacy of laser therapy with an absence of long term and unexpected side effects. In another Danish study, participants reported an average satisfaction of more than 8 on a scale of 10 after only three laser treatments. These results are even more encouraging, since currently, no alternative treatments can be proposed to the patient affected by this disabling skin disease. However, most of the women affected by this chronic skin disease as well as their treating physicians are not aware of the possibility of an effective therapy. It is this lack of awareness that denies the patient the right to move on and forget about their cancer: a right to which we as a society finally give well-deserved importance.

Hans-Joachim Laubach
President ESLD