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Your skin can itch for many reasons, such as allergies, insect bites and dry skin. The itch, called pruritus, will usually go away once you treat what¡¯s causing it. But sometimes an itch can be chronic, meaning it lasts six weeks or longer. This is known as chronic pruritus.??

In rare cases, chronic pruritus can be a sign of cancer. Here, I¡¯ll explain what types of cancers may cause itchy skin, what the itch feels like and when you should see a doctor.

What types of cancer can cause itchy skin?

Itching can be a sign of several types of blood cancers.

Lymphoma

• Cutaneous T cell lymphoma is a skin lymphoma that starts in the T lymphocytes.
• Hodgkin lymphoma and non-Hodgkin lymphoma?both start in the lymphatic system.

Leukemia

• Acute lymphocytic leukemia is a rare, aggressive type of blood cancer that starts in the bone marrow.
• Chronic lymphocytic leukemia and chronic myeloid leukemia are slow-growing types of blood cancer that mostly affect adults over age 55.
• Polycythemia vera is a chronic blood disorder in which the bone marrow produces too many red blood cells. People with polycythemia vera who experience itching have a higher chance of the disease developing into myelofibrosis and acute myeloid leukemia.
• Myelodysplastic syndrome is a group of diseases in which the bone marrow doesn¡¯t make enough healthy blood cells. Some cases develop into acute myeloid leukemia.

Itching can also be a sign of the following cancers:

• Liver cancer
• Bile duct cancer
• Non-small cell lung cancer
• Metastatic stomach cancer
• Pancreatic cancer
• Melanoma: Itching has been reported in 22% of primary melanoma skin lesions.
• Basal cell carcinoma
• Squamous cell carcinoma

Where on the body does the itching occur?

Itching can occur anywhere on the body, including the scalp and genitalia. The most common sites are the lower legs and the trunk ¨C that is, your chest, abdomen, pelvis and back.

How would you describe an itch that might indicate cancer?

There aren¡¯t specific characteristics to look for. What I mean is the itch can be:

• Localized (affecting one area of the body) or generalized (affecting the entire body)
• Constant or intermittent
• Mild to severe

Pruritus may be an associated symptom of cancer. That means it is often an additional symptom of the cancer itself. It¡¯s not necessarily a predictor of cancer. So, if you have itchy skin, it doesn¡¯t mean you will develop cancer.

Itching associated with pancreatic cancer

Itching can happen when pancreatic cancer causes a blockage in the bile duct, which can also lead to jaundice. In these cases, itching tends to be generalized. But I have seen pancreatic cancer patients with intense itching only on their trunk area, or/and only on the arms and legs.?

Aquagenic itch can be a sign of certain cancers

Aquagenic itch describes an itch that develops minutes after contact with water of any temperature with no visible skin rash. Aquagenic itch is commonly seen in people with polycythemia vera. Some people who have aquagenic itch develop cutaneous T cell lymphoma or myelodysplastic syndrome several years later.

How we classify pruritus and cancer

We divide cancer patients with pruritus into three categories:

• Patients who experienced itching before being diagnosed with cancer: A cancer diagnosis may come months to years after the itching begins.
• Patients who have an existing cancer and experience itching
• Patients who have itching indirectly related to cancer: This is usually due to the growth of a tumor affecting internal organs, such as invasive liver tumors.

Cancer treatment can cause itchy skin

Sometimes, cancer treatment can cause rashes and itchy skin. Chemotherapy, opioids, aspirin and antibiotics may cause itching.?

What other conditions can cause itchy skin?

Chronic pruritus can be caused by:

• Diabetes
• Chronic kidney failure
• Liver disease
• HIV infection
• Allergic reactions to food, medicine and insect bites
• Thyroid disorders
• Multiple sclerosis
• Anxiety
• Obsessive-compulsive disorder
• Depression
• Pregnancy

Remember: there are many reasons your skin may itch. Most of the time, it is not because of cancer.

When should you see a doctor for itchy skin?

See a doctor if you have itchy skin that:

• is all over the body, especially during pregnancy,
• starts suddenly,
• lasts for several weeks or longer,
• does not improve with moisturizer use,
• is persistent in the same spot,
• disrupts your sleep or distracts from your daily routine and/or
• is associated with other symptoms, such as weight loss, fever, night sweats, loss of appetite, jaundice, fatigue, cough or visible lumps.

If your doctor cannot find the reason for the itch, they may do a workup to check for other possible causes, including cancer. This workup includes a comprehensive review of your medical history and a physical examination, with particular attention to the lymph nodes. Your doctor will test your complete blood count, liver function, kidney function and thyroid function.

What else should readers know about itchy skin and cancer?

Itchy skin can be frustrating, especially if you don¡¯t know what¡¯s causing it. Itching can be a sign of internal disease, including cancer. We know that patients with certain cancers, namely lymphomas and leukemias, often have associated pruritus, but we have limited data indicating that itchy skin is a predictor of cancer. So, itchy skin alone does not mean you will get cancer.

See a doctor if you have persistent itchy skin and you develop other concerning symptoms. They can figure out what¡¯s causing the symptoms and get you the proper treatment.?

, is a dermatologist at MD Anderson.

or call 1-877-632-6789.

The saying goes ¡®Where there¡¯s smoke, there¡¯s fire.¡¯

Vaping seems to be an exception to that rule, as vapes, or e-cigarettes, use electricity rather than fire to convert vape liquid with substances like tobacco, nicotine, CBD and THC, into a vapor that can be smoked or inhaled.

But does this difference mean that vaping doesn¡¯t increase your risk for lung cancer and other health problems caused by traditional cigarettes? Is vaping truly a case where there¡¯s smoke but no fire?

We spoke with , to learn more about how vaping impacts the lungs.?

How is vaping different than smoking cigarettes??

Vapes differ from cigarettes, in part, because they heat liquids, not solids. Ostrin says cigarettes produce combusted plant matter that can deliver harmful chemicals directly to the lungs, leading to lung tissue destruction and lung cancer.

Still, while he says the vapor from e-cigarettes seems to be less harmful than tobacco smoking, he notes that the long-term health effects of vaping aren¡¯t yet known.?

"The effects aren't really known and some of these epidemiological facts can take decades to really be noticed. We don't have a great evidence basis because people haven't been using these heavily for decades yet,¡± he says.?

Another important distinction between traditional cigarettes and vape products is that vape products are not as regulated by the Food and Drug Administration (FDA). Ostrin says this can make it challenging for vape users to understand how much nicotine they are consuming and exactly what is in cannabis vape products like those containing THC and CBD.

Does vaping cause lung cancer?

We know that smoking cigarettes is a risk factor for several types of cancer, including lung cancer, so it is natural to wonder if vaping poses similar risks.

Unfortunately, Ostrin says that it¡¯s still too early to tell exactly how vaping impacts the lungs.??

¡°We don't really know what we're delivering into the lungs yet,¡± he says. ¡°If there are little bits of damage that build up over years, we may not see it for decades.¡±

Ostrin says there are many chemicals in tobacco smoking that can cause the lung¡¯s epithelial cells to undergo mutations that may lead to cancer. While he notes that vape liquid contains far fewer of these chemicals, it does contain some that can damage cells. However, he says that this hasn't been shown outside of a laboratory setting.

¡°Some of these have been shown in a petri dish to cause cells to become inflamed and maybe even undergo mutation, but we don't have yet the observational and epidemiologic data to show that there are cancers associated with it,¡± he says.

Cancer risk is only one of the vaping topics researchers are tackling. Ostrin says others include biological questions about vape liquid components and their impact on long-term lung health, whether vaping triggers diseases such as chronic obstructive pulmonary disease (COPD) and asthma, and epidemiologic questions.?

¡°I think there's an entire spectrum of research that is now kicking off,¡± Ostrin says.

How else does vaping impact the lungs?

There are several other lung health risks associated with vaping including some that you may have heard about on the news.

The first is EVALI, or e-cigarette or vaping use-associated lung injury. A large outbreak of EVALI occurred in 2019 when thousands were hospitalized with lung scarring and inflammation after using e-liquid thickened with Vitamin E acetate.?

Ostrin says this tragedy is an example of how unregulated the vaping industry is.

¡°People can just go, 'We're going to add chemical X, Y, Z because it's going to give more flavor, more quality,¡¯ and they have no idea about the consequences and short- and long-term damage that these chemicals are causing,¡± he says.

Vaping has also been linked to a type of lung damage called bronchiolitis obliterans, or popcorn lung, which is caused by a chemical called diacetyl used to sweeten some vape liquids.

Additionally, because vape products are unregulated, they may have contaminants.?

"Anybody can make this stuff and can refill these e-cigarettes,¡± Ostrin says. ¡°We don't know what sort of contaminants are in them, and there can be nasty stuff in there that can cause serious lung injury and body injury in general."

Finally, many vape products contain nicotine. Ostrin says that it is concerning that young people who begin vaping could develop nicotine addictions and, subsequently, begin smoking cigarettes as vapes become more regulated and less available.

¡°Our biggest concern in terms of vaping affecting the lungs is that we're going to be creating a new generation of nicotine addicts,¡± he says. ¡°I don't think we know that for certain, but it is certainly a worry.¡±

What should you do if you vape??

It may seem harmless to keep vaping, especially while research is still investigating exactly how it impacts the lungs, but quitting vapes and nicotine has concrete benefits.?

¡°Quitting nicotine is going to save you money. It's going to improve your lung health. It's better for your heart,¡± Ostrin says.?

He acknowledges that asking someone to quit nicotine is no small task.?

¡°It¡¯s one of the hardest things we ask our patients to do. It's an incredibly addictive substance,¡± he says.???

Adults interested in quitting tobacco can access resources including and , while Texas teens can get free text support through

MD Anderson patients looking to quit smoking can use the Tobacco Research and Treatment Program.?

¡°I think the best thing that any pulmonologist would recommend is to not inhale anything except fresh air and medications prescribed to you. Anything delivered into your lungs is a big wildcard,¡± Ostrin says. ¡°Delivering foreign substances into the lungs is nothing but harmful.¡±

or by calling 1-877-632-6789.?

After smoking, radon exposure is considered the second most common cause of lung cancer in the United States. It is usually suspected when someone who has never smoked or lived around anyone who smokes is diagnosed with lung cancer.?

But what is radon? How might you encounter it in everyday life? And, is there anything you can do to minimize your risk of exposure?

We spoke with vice president and head of Cancer Prevention and Population Sciences. Here¡¯s what he shared.

What is radon, and how are people normally exposed to it??

Radon is a naturally occurring, odorless, colorless, tasteless, invisible and radioactive gas that escapes from certain uranium-containing soils and rock formations. It becomes problematic when enclosed living spaces are built over these areas, typically by seeping into foundational cracks and becoming concentrated in their airspaces.?

This seepage occurs most often at the ground floor level. But depending on the state of ventilation in a particular house ¡ª or how ¡°tightly sealed¡± its windows and doors are ¡ª it could affect the upper living areas as well.

What is radon¡¯s connection to lung cancer??

The association between radon and lung cancer was originally reported in studies of underground miners, but it¡¯s been confirmed in more recent studies of household exposure, too.

When breathed into the body, radon injures the lungs slightly. Typically, it requires years of exposure before it causes any health concerns. But over time, it can cause lung cancer by damaging the cells¡¯ DNA.

How high is the risk of developing lung cancer from radon exposure??

The estimates that radon exposure causes approximately 21,000 lung cancer deaths per year in the United States. About 2,900 of those deaths occur among people who have never smoked.?

Your risk of developing lung cancer is considerably higher if you smoke and live in a house affected by radon than if you don¡¯t, but it also depends on the dose and duration of your radon exposure.

Are there any warning signs or symptoms of radon poisoning/radon-caused lung cancer??

No. Unfortunately, the first signs of significant radon exposure are often the same as the symptoms that precede a lung cancer diagnosis:

• coughing
• shortness of breath, and
• hemoptysis (coughing up blood).?

There are no symptoms specific to radon exposure that I¡¯m aware of. ?

Are there any unique features of lung cancer that¡¯s been caused by radon exposure??

Not to my knowledge. This is an area of lung cancer investigation that has previously been understudied. But no molecular signatures of radon have been identified to date.??

Is lung cancer caused by radon exposure diagnosed or treated any differently than other types??

Again, not that I¡¯m aware of, though the field of lung cancer treatment has exploded over the last decade, with many interventions directed toward specific molecular derangements.

Still, none specifically have been identified as more commonly occurring in radon- versus tobacco-induced cancers. And there is currently no clinical way of identifying patients who have this subtype of lung cancer.

What¡¯s considered an acceptable range of radon inside a home??

The Centers for Disease Control and Prevention (CDC) and the surgeon general suggest the remediation of homes when measured levels exceed 4 pCuries/L. The World Health Organization suggests home remediation at a level of 3pCuries/L or higher.

When and how often should you get your home tested for radon pollution??

The CDC recommends it:

• at the time of purchase, if it¡¯s never been done before
• before and following any renovations, and?
• before deciding to live in the lower levels of a home, such as a basement bedroom.?

This last one is because radon levels tend to be higher in the lower levels of a home than in its upper levels.

Who should consider getting radon detectors or having radon mitigation systems installed??

Anyone can have their home tested, as test kits are inexpensive and widely available.?

If radon levels are above the level recommended for action, speak with a professional mitigation specialist about sealing foundational cracks and installing a venting system.

Are there any geographical features that can increase your risk of radon exposure?

Yes. Some areas of the country are more commonly affected than others. My family home in Maryland is in such a region. When tested, we found that the ground floor had high levels; but it¡¯s now at sub-threshold levels following successful remediation. However, high radon levels have been reported in every state, so home testing is appropriate for everyone.

And, if you're at high risk ¡ª as a heavy smoker, for instance, who has also had significant radon exposure ¡ª then it¡¯s worth being screened for lung cancer. Low-dose CT screening can often detect early-stage lung cancer before it spreads.

What¡¯s the one thing you want people to know about radon exposure and lung cancer?

Understanding your risks is an essential first step in preventing cancer. So, it¡¯s worth having your home tested, if you never have before.

or by calling 1-877-632-6789.