Topical chemotherapy uses cancer drugs to kill the skin cancer cells. The drugs are creams or ointments that are applied directly on the skin cancer. The benefits of topical chemotherapy include no surgical scar, cosmetically acceptable results, and convenience.
Who is a candidate for topical chemotherapy?
Patients with early basal cell or squamous cell carcinoma or precancerous lesions that are small and shallow and have not spread to the lymph nodes may be candidates. Generally topical chemotherapy is only recommended when surgery could be disfiguring, the tumor is a difficult to treat area, and when other methods are inappropriate.
What drugs are used?
Fluorouracil (5-FU) is generic, branded as Efudexâ , Caracâ or Fluoroplexâ. This drug prevents the production of DNA in the cancer cells and without DNA they cannot reproduce. It is used to treat and superficial basal and squamous cell carcinoma, and actinic keratoses (scaly patches that are a precancerous form of squamous cell carcinoma). It is prescribed for difficult to treat areas such as the scalp and for multiple shallow precancerous and cancerous lesions when surgical options could require cosmetic restoration.
The success rate is more than 90%. It must be applied twice a day for up to 4 months until the tumors vanish. Within a week or two of ending the therapy new skin will grow to cover the area. Special precautions are required. Speak to Dr. Sadek.
5-FU doesn’t leave scars or discolored skin. However, it does have side effects including inflammation, redness, swelling and burning, and eventually exfoliation of the tumor.
In addition, there are serious side effects associated with the use of this drug. It also causes increased sun sensitivity. Efudex is not for pregnant women or those considering pregnancy or women who are nursing. People with certain hereditary conditions should not use this product.
Aldara (Imiquidmod) is used to treat small superficial basal cell carcinoma and actinic keratosis for people with a normal immune system. It works by peeling off the skin cancer. This drug ramps up your immune system stimulating it to attack the cancer cells. Aldana is not appropriate for everyone. Adara is applied once a day and kept on the skin for 8 hours or overnight, 5 days a week for six to twelve weeks. Common side effects that affect about one third of patients include redness, swelling, blistering, ulcerations, peeling, scabbing, crusting, itching and burning. The success rate is about 88%.
Dr. Joseph Sadek is a board-certified and fellowship trained dermatologist and Mohs surgeon. He will provide you with information on your treatment options, based on your type of cancer, its extent and location, and your needs. The Texas Cancer Center has offices in Houston, Kingwood and Sugarland, Texas. When you need a good dermatologist, who provides state-of-the-art treatments and procedures in a compassionate and respectful setting, contact him.