Becky Sasaki has the quick laugh and easy smile of a woman who continues to thrive despite her four-year wrestling match with lung cancer.
She still works every day in the family business, heads out for Thai food with her husband and baby sits for her energetic grandchildren.
This winter when the cancer, which had metastasized, appeared in her brain for the third time, her oncologist prescribed a new breed of targeted cancer drugs to shrink the tumor. But before she could even fill the prescription, her doctor dispatched her to the Cancer Skin Care Program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.
The goal: save her skin so she can continue to enjoy her active life.
The targeted cancer drug she was about to take can have such disfiguring dermatologic side effects, some patients are embarrassed to be seen in public and hide at home. Others can't bear the extreme skin problems, such as severe acne, and toss their pills.
Mario Lacouture, M.D., founder and director of the pioneering Cancer Skin Care Program, waited patiently for Sasaki until 6:30 p.m., the soonest she could arrive from her appointment with the oncologist. Lacouture wanted to arm her with an arsenal of specially formulated lotions and drugs to head off potentially devastating skin problems. He launched the skin cancer program – the first in the country – about a year ago to parry the painful skin conditions caused by these drugs.
"We are trying to help people keep their dignity and quality of life," said Lacouture, an assistant professor of dermatology at Northwestern's Feinberg School of Medicine and a dermatologist at Northwestern Memorial Hospital. He often sees patients the same day they call for an appointment, an intentionally lightning-fast response. Generally, patients need to wait weeks or longer for an appointment with a dermatologist.
"These people don't have that luxury of time," explained Lacouture. "If the side effects become severe, they are taken off the anticancer medicines." He keeps half of his weekly schedule open so he is always available for urgent, last minute appointments. And the clinic phone number is actually a pager to a nurse coordinator, so cancer patients receive a swift return call.
When Lacouture met with Sasaki, he prescribed four specially formulated creams including sunscreen, a body moisturizing cream to ward off the severely dry and itchy “alligator” skin, a topical steroid ointment for her face and medicated shampoo. He also recommended an ophthalmologist for dry eyes -- another unpleasant side effect.
“This has made a huge difference,” said Sasaki, 57, a Chicago resident. “I can't even imagine what I would look like at this point without these medications. You don't want to go out and get stared at.”
As new skin problems erupt – like the recent painful, split skin on her fingers – Sasaki visits Lacouture for new potions.
Cancer patients' skin problems erupted in 2004 with the emergence of a powerful new class of chemotherapy agents. These agents attack specific proteins in cancer cells rather than the “spray gun approach” of conventional chemotherapy that "basically shoots at everything and kills all kinds of cells,” Lacouture said. The new agents minimize the side effects of traditional chemotherapy so patients lose less hair and don't suffer from plummeting white blood cell counts, which leave them vulnerable to infections.