Mid to long term treatment of Hand & Foot syndrome

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Hello
I started to do some personal research on Hand And Foot Syndrome (HFS) when it seemed likely that I would go on the SORCE trial following a diagnosis of Renal Cell Carcinoma (RCC) and my subsequent nephrectomy.
Hand and foot syndrome or hand to foot syndrome, Palmar- Plantar Erythrodysesthesia is a side effect which can occur with several types of chemotherapy or biologic therapy drugs used to treat cancer.
Following administration of chemotherapy small amounts of the drug leak out of the capillaries in the palms of the hand and soles of the feet.
Heat and or friction increases the amount of the drug in the capillaries and increases the amount of drug leakage.
This leakage results in redness, tenderness and possibly peeling of the palms and soles.
The redness, Palmar-plantar erythema looks like sunburn.
The feet can become dry and peel with numbness or tingling developing.
HFS can become painful and interfere with your ability to carry out normal activities.
The condition, probably first described in 1974 in a patient receiving mitotane (Lysodren),[1] was defined in a 1982 case study of a patient receiving a cytarabine-containing chemotherapy regimen.[2] The development of hand-foot syndrome appears to be predominantly drug and dose dependent, with peak plasma drug concentrations, total cumulative dose, and administration schedule affecting onset and severity.[ 3] Consequently, the time of onset is variable, ranging from 24 hours to 10 months after the start of chemotherapy. Hand-foot syndrome is usually self-limiting and rarely leads to hospitalization or life-threatening manifestations. However, if it is not recognized early and managed effectively, an initially mild, cutaneous reaction can progress to an extremely painful and debilitating condition that can have a considerable impact on a patient's quality of life.( Werner Scheithaur,MD and Joanne Blum, MD,PHD.)
I am not sure I can post links but http://www.cancernetwork.com/display/article/10165/107123 or simply Google for more information.

‘To date, the only method shown to effectively manage hand-foot syndrome is interruption of treatment and, if necessary, dose reduction.’

One recommendation was to reduce walking and use of hand tools.
RCC is bad enough but not being able to walk to the pub or use a corkscrew is simply intolerable.
So off to the cancer forums. Sadly very little info on podiatry websites. Loads of anecdotal suggestions for remedies. Udder cream topped the list! Nicotine patches have a certain allure for an ex (ish) smoker.
A lot of the early chemotherapy regimes were really ‘nasty’ drugs and HFS was only one of the minor side effects. Grit your teeth and get on with it. Also a lot were administered in bursts or pulses. Two weeks on one off etc.

However recent treatment therapies are much more mid to long term.
Sutent although pulsed four weeks on and two off is a mid to long term therapy.
The SORCE trial ( sorafenib) is a phase 3 trial for three years.

At about this stage in my research the results of my first regular twelve weekly CT scan came through. The best possible news all clear.
The recommendation from my medical team was not to take part in the SORCE trial. ( my age 60 may have been a factor)
Back to work.
In the first two weeks three patients on drug trials.
Two are being treated with Capecitabine one is on the SORCE trial.
The two now being treated with Capecitabine are longstanding patients. As such I can make a comparison. The drug seems to have had the effect of magnifying existing conditions. Dry skin heel fissures etc.
The patient on the SORCE trial was a new patient. ( SORCE is a blind trial and as such it is possible he is receiving the placebo.)
53yr old male with a sedentary lifestyle who two weeks after starting the trial needs treatment to, for the first time ever,bilateral painful mid plantar callus.
He presented with all the other conditions associated with HFS but the callus was the dominant problem.
Standard palliative treatment helped all patients. I didn’t use udder cream.
All help, advice and previous experience of treating this condition gratefully received.
Chris