Acronym Definition
HFSR Hungarian Foundation for Self-Reliance
HFSR hand foot skin reaction
HFSR high frequency spectral ratio
HFSR Hard Fuse Shift Register
HFSR high flux subcritical reactor
HFSR Household Food Security and Resilience
HFSR 合肥市容
HFSR Half Sister
HFSR Australian Department of Health and Family Services Resource
HFSR Hartree-Fock Slater Resource
HFSR Health and Family Services Resource
HFSR Health Food Store Resource
HFSR Healthcare Facilitation Services Resource
HFSR Hemifacial Spasm Resource
HFSR Heritage Family Study Resource
HFSR Hierarchical File System Resource
HFSR High Fantasy Society Resource
HFSR High Fidelity Simulator Resource
HFSR Higher Frequency Subband Resource
HFSR Hospital Formulary System Resource
HFSR Hot Fuel Storage Resource
HFSR Hrvatska Udruga Filmskih Snimatelja Resource
HFSR Human Factors Society Resource
HFSR Hydrogen Forward Scattering Resource
HFSR Home of Facilities Service Request
HFSR Home of Facilities Support Requirement
HFSR Home of Facility Safety Review
HFSR Home of Family Support Registry (Denver, Colorado, USA)
HFSR Home of Farming System Research
HFSR Home of Fast SRNC Relocation
HFSR Home of Feasibility Study Report
HFSR Home of Field Service Report
HFSR Home of Field Service Representative
HFSR Home of Fielded System Review
HFSR Home of Fielding Status Review
HFSR Home of Filter Self-Rescuer (mining)
HFSR Home of Final Systems Review
HFSR Home of Financial Service Representative
HFSR Home of Financial Services Reform (Australia)
HFSR Home of Financial Services Roundtable (formerly Bankers Roundtable)
HFSR Home of Financial Strength Rating
HFSR Home of Financial Systems Review
HFSR Home of Finlandssvensk Radio
HFSR Home of Fisheye State Routing (communication protocol)
HFSR Home of Fixed Price Contracts with Price Redetermination
HFSR Home of Fjernskriver Ratt (Norwegian)
HFSR Home of Flight Safety Rules
HFSR Home of Floor Space Ratio (architecture)
HFSR Home of Florida State Referees, Inc (soccer)
HFSR Home of Fluorosilicone Rubber
HFSR Home of For Some Reason
HFSR Home of Force Sensing Resistor
HFSR Home of Force Structure Review
HFSR Home of Forecast Stock Return
HFSR Home of Foreign Separate Rations
HFSR Home of Forest Service Road
HFSR Home of Former Soviet Republic
HFSR Home of Fourier Series Representation
HFSR Home of Fractionated Stereotactic Radiosurgery (medical/cancer treatment)
HFSR Home of Fractionated Stereotactic Radiotherapy
HFSR Home of Free Space Range
HFSR Home of Free Spectral Range
HFSR Home of Frequency Scan Radar
HFSR Home of Frequency Select Receiver
HFSR Home of Frequency-Shifted Reference
HFSR Home of Full Scale Range
HFSR Home of Full Scale Record (instrumentation)
HFSR Home of Full Scale Reference
HFSR Home of Full Spectrum Recorder
HFSR Home of Functional Support Requirement
HFSR Home of Fund Summary Record
What Is Hand-Foot Skin Reaction?
Cancer therapies are used to attack or interfere with tumor cells, but
different therapies may affect different types of normal cells as well. Some
cancer therapies affect cells called “epithelial cells.” Epithelial cells can be
found in the skin, in the intestines, and elsewhere. Epithelial cells form a
protective layer on the inside and outside surfaces of organs. When cancer
therapies affect epithelial cells, side effects may result. One such side effect
that affects the skin is hand-foot skin reaction (HFSR).
HFSR is the name for a group of symptoms that affects the hands and/or
feet of patients taking certain cancer therapies. Usually the symptoms
affect both the left and right sides of the body. The symptoms listed below
may occur one at a time, more than one at the same time, or not at all.
1
Common symptoms of HFSR include:
• Numbness, tingling, or a “pins and needles” feeling
• Increased skin sensitivities
• Pain when touching hot objects
• Burning sensation
• Redness
• Swelling
• Buildup of hard skin or calluses at pressure points,
like the heels or balls of your feet
• Blistering
• Dry and/or cracked skin
• Peeling and/or flaking skin
3
epithelial cells
dermis
hypodermis
epidermis
Page 4
4
What is the difference between mild and severe HFSR?
Symptoms of HFSR can range from mild to severe, and doctors use a
“grading system” so they can classify side effects like HFSR to help them
decide how to manage these symptoms. The table below describes the
3 grades of HFSR, with Grade 1 being mild and Grade 3 being severe.
Grading System for HFSR
1-3
Grade
Symptoms
• Numbness
• Unpleasant sensations when touching
ordinary things
• A burning or prickling feeling
• Tingling
• Painless swelling
• Redness or discomfort of hands or feet
• None of these symptoms affect the patient’s
normal daily activities
One or more of the following:
• Painful redness
• Swelling
• Skin thickening of the hands or feet
• Symptoms create discomfort but do not affect
the patient’s normal daily activities
One or more of the following:
• Scaling or shedding of skin
• Open sores
• Blistering
• Skin thickening
• Severe pain of the hands and feet
• Severe discomfort that causes the patient to be
unable to work or perform daily activities
How will my doctor or healthcare professional treat my HFSR?
It is important to tell your doctor or healthcare professional as soon as you
notice any signs or symptoms of HFSR because treating these symptoms
early when they are still mild may prevent them from getting worse.
1
If the symptoms do get worse, your doctor may need to interrupt treatment,
reduce your treatment dose, or discontinue therapy. If interrupting treatment
is required, you and your doctor will decide when to resume treatment.
1
Your doctor or healthcare professional will decide how your symptoms
will be managed. Your doctor may decide to refer you to a dermatologist,
depending on your symptoms. Below are some suggestions your doctor
may recommend that you follow
1,4
:
• Wear cotton socks or gel inserts and avoid pressure points by
wearing soft shoes or tennis shoes and not standing for long
periods of time
• Mix Epsom salt (magnesium sulfate) and lukewarm water,
and soak the affected skin in it
• Use urea-containing creams or other lotions on your feet, either twice
daily or apply a generous layer to your feet overnight and cover your
feet with socks to retain the cream and protect your bedclothes
—Some products you may want to try:
—Dr. Scholl’s
®
Callus Exfoliating Ointment
—Dermal Therapy™
—Kerasal
®
—Udderly Smooth
®
This is not an exhaustive list. Ask your doctor about other options.
• Apply sunburn relief spray to the affected areas when needed
5
• Treat your feet to a pedicure if you have preexisting buildup of hard
skin and calluses on your feet because this may help prevent the
development of HFSR
—Use hydrating cream immediately after a pedicure to prevent
further hardening of your skin
FPO
Page 7
7
Page 8
What types of rash sometimes happen with cancer therapy?
Some patients on cancer therapy develop rashes on the face and/or body.
These rashes are separate from HFSR and usually appear early in treatment.
Three different types of rash may develop
1,2,6
:
• A facial rash
—Usually red with slight peeling of the skin near the
eyebrows and hairline
—Usually presents in triangular pattern involving both
cheeks and your chin
—Heat may aggravate symptoms but is not bothersome
for the most part
—Sometimes there is an uncomfortable tingling or
burning sensation on the scalp
• A rash on your body, called a “maculopapular rash”
—Skin is discolored, with small, raised bumps
—May be itchy
—May cover only your upper body and arms or it may cover
your whole body
• A red body rash with small blisterlike bumps (rarely occurs)
—May cover only your upper torso area and arms or it may
cover your whole body
These rashes tend to fade with time, but some skin discoloration may remain.
How are these rashes managed?
Doctors and nurses offer the following suggestions to reduce discomfort
and prevent these types of rashes from getting worse
4,5
:
• Use moisturizing creams on your skin immediately after a shower and
before going to bed from the start of your therapy, if possible
• Use anti-itch formulas of moisturizing creams if the rash itches
• Use an antidandruff shampoo:
—To relieve scalp discomfort
—As a body wash to relieve itchy skin
• Wear loose clothing
• Avoid hot showers
• Avoid direct sunlight
• Use sun protection of at least 30 sun protection factor (SPF)
Ask your doctor or pharmacist for more information. Remember: your
doctor or healthcare professional is the best source of information
regarding you and your health.
Questions for your doctor
• What can I do to prepare myself for any side effects that may occur
during treatment?
• When do side effects such as HFSR and rash usually appear with this
particular treatment?
• Do side effects tend to improve over time?
• If I have one of these side effects, will it affect how much cancer
therapy I receive?
• Do I need to discontinue therapy if side effects occur?
• What can I do to manage or prevent any side effects like
HFSR or rash?
• What are all the signs or symptoms I need to watch out for and
report to you right away?
Write down any other questions you have about your therapy, so you can
ask your doctor or healthcare professional.
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