Dermatologists: Don’t just send your patients out the door to a hematologist-oncologist when their early stage cutaneous T-cell lymphoma progresses.
“I encourage dermatologists to stay involved, even with stage IIB or III patients. We know clinically what is going on, but a lot of times dermatology tends to drop out of the game,” Dr. Frank Glass said at the Florida Society of Dermatology and Dermatologic Surgeons meeting.
Dr. Frank Glass
“Many patients tend to get overtreated if they are not anchored by what we’re doing in dermatology.” Chemotherapy is an example. “The consensus is that survival is likely to be the same even with aggressive chemotherapy,” said Dr. Glass of the University of South Florida College of Medicine in Tampa.
“The oncologists are really moving away from doing chemotherapy, really because of the cross-pollination with dermatologists,” said Dr. Elise Olsen, professor of dermatology and oncology at Duke University. ”This is a big shift for oncologists.”
Dr. Elise Olsen (photos by D. McNamara)
The latest update to cutaneous T-cell lymphoma guidelines from the National Comprehensive Cancer Network–which recommend immunomodulators first and chemotherapy second–are a positive sign of increased collaboration between these specialties, Dr. Olsen said. “It’s important for patients to come through us … so we can try immunomodulators first.”
A move toward greater collaboration is coming in the form of the United States Consortium for Cutaneous Lymphomas. Dr. Olsen is working with dermatologists, oncologists, radiation oncologists, and other clinicians to set up this new multidisciplinary effort. A web site and registry for early-stage patients is forthcoming.
Dr. Olsen wants physicians to enter their early stage patients, even those in remission, to the registry. ”We want to see if there are pockets of [cutaneous T-cell lymphoma] around the country, to look for environmental factors.”
– Damian McNamara