Guests/Speakers
Dr. Olivia Fankuchen, MD, MSc: Thoracic medical oncologist, lung cancer specialist, and cancer researcher at Weill Cornell Medicine in New York
Jeanne Szurek: Patient host and patient advocate, living with lung cancer
Preventing Skin Side Effects From Lung Cancer Treatment: Why Starting Early Matters
Many of the newest lung cancer treatments are more targeted and more effective than ever. But some can also cause skin side effects like rash, dryness, or irritation around the nails. In this Fall 2026 episode of Hope With Answers, patient host Jeanne Szurek talks with thoracic medical oncologist Dr. Olivia Fankuchen of Weill Cornell Medicine about proactive therapy management (PTM): preparing for skin side effects of lung cancer treatment before they start.
Jeanne knows this topic firsthand.
“I remember thinking that if a rash developed, I’d just deal with it. But my care team told me that managing side effects early might actually help me stay on my treatment, and it’s actually worked for me.” — Jeanne Szurek
What Is Proactive Therapy Management?
Dr. Fankuchen describes PTM as her toolkit for protecting patients from the start. When she recommends a treatment known to cause skin problems, she builds prevention right into the plan. That way, patients can keep getting the treatment most likely to help them.
Why Skin Side Effects Matter
A rash is more than a minor inconvenience. As Jeanne points out, something visible and uncomfortable every day can affect your confidence, your sleep, and whether you want to leave the house. Dr. Fankuchen adds that skin is a key part of the body’s defenses.
“Keeping your skin healthy means keeping your body healthy, which means giving you the best opportunity to stay on treatment.” — Dr. Olivia Fankuchen
When skin reactions become severe, care teams may need to lower a dose, pause treatment, or switch therapies. Prevention helps avoid getting to that point.
What a PTM Routine Looks Like
The routine is simple, and the products are easy to find. Depending on the treatment, it may include:
- Gentle ceramide or antibacterial washes
- Protective creams
- A preventive antibiotic, in many cases
- Most importantly, telling your care team when something feels different
Timing matters too. Dr. Fankuchen likes patients to start before cancer treatment begins, sometimes about a week ahead depending on the treatment, so prevention is already working when cancer treatment starts. Some of her patients begin treatment within days, so she prescribes what’s needed at the first visit and hands patients their creams and washes as they leave the clinic.
“I want it to be working so well that you never notice a problem.” — Dr. Olivia Fankuchen
See the four-part routine and timeline on the Proactive Therapy Management page, then ask your care team about a skin care plan.
Making It Manageable
Cancer care already comes with appointments, scans, and paperwork, so one more routine can feel like a lot. Dr. Fankuchen says some patients embrace PTM as self-care, while others lean on caregivers, reminder diaries, or help from nurses in the clinic. Caregivers and loved ones can also be the “eyes and ears” outside the clinic, noticing a rash in a place the patient can’t see.
What to Watch For, and When to Call
Dr. Fankuchen encourages patients and caregivers to watch for dryness or flaking, redness, itching, rash, cracking around the fingernails or toenails, and irritation or pain in the mouth. Call your care team right away if you have a fever or feel really sick.
Not sure how to bring up side effects? See How to Talk to Your Doctor.
Speaking Up Helps You Stay on Treatment
Many patients hold back because they don’t want to complain, or they worry that reporting side effects will cost them their treatment. Dr. Fankuchen says the opposite is true.
“We actually have a much harder time keeping you on treatment if we don’t know you’re having some side effects before they become severe.” — Dr. Olivia Fankuchen
The same applies to clinical trials. Reporting side effects helps the research team monitor you safely and shapes how future patients receive the treatment.
Exploring a clinical trial? Find a Clinical Trial with LCFA
Asked what listeners should take away, Dr. Fankuchen keeps it simple:
“Communicate, communicate, communicate. Tell us how you’re feeling.” — Dr. Olivia Fankuchen
