What to Expect: Topical Chemotherapyby Eileen Bailey Health Writer
For some skin cancers, non-melanoma cancers confined to the top layer of skin, a topical chemotherapy cream may be prescribed. This type of treatment is most often used for squamous cell carcinoma, basal cell carcinoma and actinic keratoses. For more aggressive cancers, other treatment options should be explored. Sometimes these creams are prescribed in addition to surgery to remove the cancer.
Two commonly used topical chemotherapy creams include Imiquimod (IMQ) and 5-fluorouracil (5FU). These creams work in different ways to fight cancer cells. IMQ stimulates your immune system to destroy cancer cells. 5FU works by preventing rapidly dividing cells from growing.
Advantages of Topical Chemotherapy Creams
When used instead of surgery, topical creams cause less scarring. If precancerous cells are found nearby to the primary tumor site, applying the cream can sometimes stop these cells from becoming cancer. In addition, the treatment is self-applied, at home rather than going to the doctor's office or hospital for treatment.
Disadvantages of Topical Chemotherapy Creams
These types of treatment can make you more uncomfortable during hot months and makes you more sensitive to the sun. It is usually recommended to be used during cooler months so the heat and humidity do not cause you to be uncomfortable or further inflame and irritate the area.
During the course of treatment, which can be lengthy, your skin will look red, raw and inflamed. It is imperative that you follow instructions for application and wound care carefully. Moisturizers, specifically petroleum based moisturizers, can help with some of the discomfort. Cortisone creams may also help.
Because there is not a biopsy done, it is not always clear whether or not the treatment was successful and that all the cancer has been treated.
Application of Topical Creams
Topical chemotherapy creams are self-applied at home. Depending on the medication and your cancer, your doctor will give you instructions of how often to apply the medication. Some, such as 5FU, are usually applied twice a day, typically for between 6 and 12 weeks. Because you can experience a number of side effects, such as inflammation, redness and intense skin irritation, your doctor may want you to "cycle" the treatment, meaning that you apply the medication twice a day for a certain number of days, then stop for a period of time, and then apply it again for a certain number of days. This can help reduce the side effects.
These creams are also used to treat pre-cancerous lesions, called actinic keratoses. When used for this purpose, they are typically applied for up to 3 weeks. Around the second week, the area becomes red, swollen and scabby. Once the treatment stops, the scabbed skin falls off and new, healthy skin grows.
"Chemotherapy: What Every Patient Should Know," Date Unknown, Staff Writer, American Academy of Dermatology
"Skin Cancer," Reviewed 2009, July 21, Staff Writer, U.S. News and World Report
"Skin Cancer Treatment," Date Unknown, Staff Writer, National Cancer Institute