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Cancer is such a feared possibility that many people worry about signs and symptoms that are unlikely to mean cancer. Cancer itch is one of those symptoms that cause worry in healthy people as well as patients undergoing treatment for an actual diagnosis of cancer. While there are a few cancers that cause cancer itch, the overwhelming majority of itching is not related to cancer. We’ll discuss some of those causes, and then examine cancers that may in fact cause cancer itch.

Common Causes of Cancer Itch in Patients

While itching can be annoying, you should not usually worry about it. Most often, the cause is dry skin caused by spending hours in a dry hospital environment or repeated cleaning of the skin while undergoing treatment. To help resolve itching, use a rich body lotion or cream after showering or bathing, and be sure to drink plenty of water.

Another common cause of itching can be an allergy. While you are preoccupied with your cancer, you may not be as vigilant about avoiding things you are allergic to. Do a mental review of your diet and the places you’ve been to see if you may have been in contact with one of your triggers. An antihistamine and avoiding your allergens may be all you need.

Some patients experience itching or flushing while undergoing treatment for cancer. In this case, itching may begin almost immediately after the start of the infusion. Tell your doctor or your nurse if this happens to you. Some drugs commonly cause a skin reaction and an itch. In this case, the drug can be stopped temporarily and then resumed at a lower pace. If the itching persists, your doctor may prescribe a stronger antihistamine or change your treatment protocol to make you more comfortable.

Cancers That Cause Cancer itch

Although most itching is not caused by cancer, there are some times when itching may indeed be one of the many cancer symptoms. If you experience intense itching and it is not relieved with lotions, antihistamines or avoiding your allergens, call your doctor to seek advice.

If you experience intense itching and it is not relieved call your doctor. Share on X

Some common cancers that can cause cancer itch are the following. The most common cancers to cause itching are hematological malignancies such as Hodgkin’s lymphoma, leukemia, cutaneous T-cell lymphoma and biliary malignancies. In cases when the itching is chronic and there are no skin changes, a cancer needs to be considered. Here are some cancers that can cause itching:

1-Biliary Tract Cancers:

The biliary ducts are the structures that transport the bile from the liver and gallbladder into the intestines to help with digestion. Cancers of the biliary ducts can block the release of bile and the backup of substances in the blood that can cause itching. If this is suspected, your doctor will order blood tests to check the level of these substances.

2-Skin Cancer

The most common cause for itching with cancer is skin cancer. Share on X

Basal cell carcinoma and squamous cell carcinoma are the most common types of skin cancer and are treatable. They can cause cancer itch in around 40% of the cases. Four million people are diagnosed with either one of those two cancers every year. This means that around a million people will feel itching due to skin cancer. The itching of those two cancers is usually mild and does not require treatment and goes away after the cancer is removed. If you have a suspicious mole that has changed in color or size or a sore that also itches, you should follow up with a dermatologist who can examine it and possibly biopsy it to rule out skin cancer.

Melanoma, the deadliest form of skin cancer, rarely causes cancer itch. Still, as above, if you are concerned about a new lesion that is changing shape and color, you need to get it checked.

2-Cancers that have progressed to the liver

Tumors that affect organs such as lungs, colon, breast, brain, muscles are called solid tumors. These tumors rarely cause itching. They can indirectly cause itching however if they progress to involve the liver. In this case, the itching is caused by the irritation to the liver rather than the actual lung cancer. If you experience symptoms of jaundice along with the itching, you should see a doctor for diagnoses and treatment.

3-Leukemias and lymphomas

Cancers of the blood or lymph nodes such as Hodgkin’s lymphoma, leukemia and cutaneous T-cell lymphoma have been associated with cancer itch. When associated with lymphoma, itching usually involves the legs and has a burning sensation. It can occur in up to 25 percent of patients.

With cutaneous T-cell lymphoma, Itching can be more common because of the skin involvement.  Cutaneous T-Cell Lymphoma often causes itching in the dry, scaly patches that develop in the early stages of this disease. It is thought that in this case, the secretion of inflammatory markers like interleukin-31 is the reason for the itching.

In addition to the cancers themselves, it is important to remember that itching can be the side effect of treating lymphoma rather than a symptom of the disease itself. If you develop any symptoms after the initiation of treatment, let your treating team know immediately.

4-Paget Disease

Paget disease is a form of breast cancer. It is also known as Paget disease of the breast, Paget disease of the nipple or mammary Paget disease. This disease takes its name from Sir Thomas Paget, a British doctor. In 1874, Sir Thomas Paget noticed a relationship between itching of the nipple and breast cancer.

Paget disease is diagnosed by the presence of “Paget” cells in the epidermis. These abnormal cells are large, round and may be found in clusters or as a few single cells. Symptoms include itching, flaking or crustiness on the nipple or areola, a flat or inverted nipple or a discharge from the nipple. People with Paget disease almost always have a tumor in the same breast. Both men and women can have Paget disease.

Possible treatments of Paget disease include mastectomy, lumpectomy, removal of the nipple, radiation or chemotherapy, depending on the existence or absence of internal tumors in the breast. Eliminating Paget disease eliminates the itching.

Regardless of your gender, if you notice itchy nipples, have a discharge from a nipple or have recently inverted nipples, you should see a doctor. The doctor will examine biopsied cells to determine the diagnoses.

Cancer Treatment

When the itching is due to cancer, the most important treatment is to treat the cancer first. When the cause of the itching is treated, the itching improves or resolves. There are many types of treatment such as surgery for skin cancer, chemotherapy and radiation for other types of cancers. These treatments can cause itching on their own

If you experience itching or flushing during or soon after your chemotherapy session or treatment with other drugs, you should talk to your doctor right away. Drug reactions can be serious, and your doctor can offer advice on the best ways to minimize or eliminate the reaction.

When the itching is due to cancer, treat the cancer first. Share on X

Treating the Itch

During your treatment you should take the time to pamper yourself with rich lotions or creams to help keep dry skin at bay. Rubbing in the lotion is also soothing and may help alleviate tension. Always apply lotion after showering or washing your hands to keep the skin supple and itch free.

A soothing scent such as lavender can help you relax, but be aware that some people can react to the fragrance in lotion. If you think it could be the fragrance causing the itch, switch to an unscented version or choose a lotion for people with sensitive skin.

Remember to avoid all allergens, especially foods or over the counter medications that can cause itching. If you do experience mild itching, an over the counter oral antihistamine or cream may resolve the issue. You should check with your doctor before taking any medication while undergoing cancer treatment to avoid the possibility of drug interactions.

However, if the itching comes on suddenly after the start of chemo or after taking any prescription medicine, or if the itching covers your entire body, you should talk to your doctor right away. These symptoms could be a sign of a dangerous drug allergy. Your doctor may want to change your treatment protocol or add a powerful antihistamine or other drug to control the allergic reaction. At the very least, he may want to have someone stay with you or check on you frequently during treatment to watch for signs of a drug reaction.

There are many drugs that have been tried to help with itching related to cancers. There are no big studies to draw definite conclusions but among the medications that have been tried successfully are Paroxetine, an antidepressant and thalidomide. Gabapentin and Mirtazapine have been used for cutaneous T cell lymphomas as well as steroids. Newer medications are also being investigated

Conclusion:

A cancer diagnosis—or even just a general fear of cancer—can make you hyper-alert to signs and symptoms. Rest assured that with very few exceptions, itching is rarely a sign of cancer and can be safely treated with over the counter remedies. For those cancers that may cause itching–skin cancer, Paget disease or lymphoma among them, look for the additional symptoms that can alert you to the presence of the disease.

If you are concerned, you should always talk to your doctor. Nobody knows your body as well as you do, and if you feel something is not right, keep asking until you receive a diagnosis. Also, don’t forget to check the most common cancer symptoms in this article.

In conclusion, there appears to be an increased awareness about the toll cancer drug prices are taking on American families. While no immediate solution has been implemented, an increased media exposure and physician awareness could be the harbor of a fairer pricing value system in the near future.

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Michel Choueiri

Michel completed his Oncology training at the University of California at San Diego and specialized in cancers of the kidneys, prostate and testicular cancer at the MD Anderson Cancer Center. With the constant changes in diagnostic tests and treatment options, he believes every patient should have access to the highest level of care.

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