Dermatology question?

[Brandi]

I have very fair skin and always go see my dermatologist. This past visit he wants me to do this knarely cream on my chest cause he see's precancerous spots on my chest. I don't see them but I am not a Dr. This cream seems kinda scary. Not that cancer isn't but has anyone ever done this kind of treatment. I used a less evassive cream the last 2 years for like 6 months at a time but it I guess is not enough, this other stuff is more short term and I guess you really see what it does. Your skin gets all crusty and gross I guess. I am a little scared. I wish I didn't like to be outside so much! Biking and hiking are my fav things to do. But I do wear massive sunblock and cover myself now. But I was a california girl growing up so I am paying the price now. But again I don't know what he is seeing. I though my chest looked pretty good!

[maillotpois]

They have the little viewer things and they can look at your cells very close up and see damage that you just can't see. Trust the doctor. If they think there are cells you need to get rid of then do what they say.

(This is from someone with a divot out of her leg from listening to her dermatologist and grateful for it.)

[lunacycles]

I question whether one should trust the doctor given my experience of over half a dozen basal cell carcinomas being treated in the "conventional" way.
If the cream being presicribed is Aldara, then it's a cream which will attack a skin cancer and draw it out. And, if it's more than pre-cancerous, it can be a process, and somewhat painful. (If you google it, beware, as you will hear horror stories in addition to those which praise it.) I used Aldara on the back of my neck, and while it "responded" fully (i.e., created a festering wound which took about a month to heal), it also made my lymph nodes in my neck go berserk-- which no one warned me of, and cost me a trip and tests with an ENT specialist who thought I might have lymphoma... = $$$...blah blah. Plus the Aldara itself, like 3 grams, ran me over $200. Ridiculous.
Anyway, Aldara is apparently effective, and probably going to do the trick more than the conventional "freezing" (which I've done to mixed effect, but has resulted in an 8" scar on my arm when it did nothing but bury the cancer and then a much larger area had to be cut out) and while Aldara was effective for me, it was somewhat traumatic to use.
I now avoid dermatologists as much as possible, because the ones I've encountered have not been real sharp, have been expensive, and generally caused disfiguring results.
Knowing skin cancer will probably be a recurring part of my life from here on out I now rely on a (subversive, off-the-map) herbal black salve to treat pre-cancerous, or cancerous spots (am not bothering with the biopsies, I know what they look like) to treat my "spots," so far to good effect. It works like aldara, but I am in charge and this makes me happy.
That was no doubt TMI, but good luck to you. Skin cancer sucks, but it's better than other cancers, but it requires a life-long commitment to keep at bay if you are fair skinned and have suffered a lot of sun exposure.
p.s., use sun screens that are not chemically based, whenever possible. I have done so and my skin cancers have decreased dramatically.

[Brandi]

I am to use a cream called fluorouracil. As far as sunscreen what kind do you use Lunacycles? My dad has had many chunks taken out of him. Again California surfer boy who became a gardner and STILL doesn't use sunblock. I protect myself now. I know my Dr sells a lot of stuff to people and I don't want to be one of those I just want to be looked after.

[lunacycles]

Here's my 2-second search on fluorouracil, from Wikipedia:

http://en.wikipedia.org/wiki/Fluorouracil
The chemotherapy agent 5-FU (fluorouracil), which has been in use against cancer for about 40 years, acts in several ways, but principally as a thymidylate synthase inhibitor. Interrupting the action of this enzyme blocks synthesis of the pyrimidine thymidine, which is a nucleotide required for DNA replication. Thymidylate synthase methylates deoxyuridine monophosphate (dUMP) into thymidine monophosphate (dTMP). Facing a scarcity of dTMP, rapidly dividing cancerous cells undergo cell death via thymineless death[1].

Like many anti-cancer drugs, 5-FU's effects are felt system wide but fall most heavily upon rapidly dividing cells that make heavy use of their nucleotide synthesis machinery, such as cancer cells (other parts of the body with rapidly dividing cells include the cells lining the digestive tract).

Some of its principal uses are in colorectal cancer, and pancreatic cancer, in which it has been the established form of chemotherapy for decades (platinum-containing drugs approved for human use in the US since 1978 are also very well established). It is also sometimes used in the treatment of inflammatory breast cancer, an especially aggressive form of breast cancer.

5-FU is also used in ophthalmic surgery, specifically to augment trabeculectomy (an operation performed to lower the intraocular pressure in patients with glaucoma) in patients deemed to be at high risk for failure. 5-FU acts as an anti-scarring agent in this regard, since excessive scarring at the trabeculectomy site is the main cause for failure of the surgery.

Fluorouracil can be used topically (as a cream) for treating actinic (solar) keratoses and some types of basal cell carcinomas of the skin. It is often referred to by its trade names Efudex, Carac or Fluoroplex.

Due to Fluorouracil's toxicity and the fact that it can be manufactured using the same reaction as uracil, its precursor, 5-Fluoroorotic Acid, is commonly used in laboratories to screen against organisms capable of synthesizing uracil.

It is a key component in Tegafur-uracil.

If you go to the "side effects" section, it sounds rather intense. this seems like a strong drug for something which is supposedly "pre-cancerous."

Regardless, I lately use sunscreen by Mychelle. It's SPF 25 I believe, and available at places like Whole Foods or Vitamin Cottage.

Good luck to you.

[Brandi]

I believe some of the side effects you might be reading have more to do when it is not used topically. But the dermatitis side effect probably applies.

[AnnieBikes]

I, too, am very fair and had multiple sun burns as a child and teen. Now I use sunblock whenever I am outside. I have had several procedures to remove basal cell cancers from various areas of this aging body! I used to go to a dermatologist, but he would "biopsy" the lesion and then have me come back a second time to remove whatever it was. Ridiculous. I started going to a wonderful surgeon. He looks at them, decides if they can be treated topically and, if not, excises them with a local anesthesia. Biopsy and removal in one step. I have used Aldara once on a lesion on my jaw and it worked very well. Yes, I got an ugly thing but it took away the lesion for good.

Presently, I am using Efudex (5-FU) cream on a lesion on my hand. After week or so of 2x daily use, it makes a raw area and then it heals and the lesion is gone.

I have a wonderful DH, who also happens to be a retired oncologist, so he watches out for any changes in moles, lesions, or whatever, that I have on me. If he recommends a removal, as opposed to the Efudex cream, then I go visit the surgeon and he takes it off.

[Brandi]

You know it is funny though I really don't see what he is seeing. I have a lot of freckles on my chest but if he is seeing lesions they must be micro. I mean my skin is not the smoothest but I am 42. But at the same time I can wear a scoop neck top and people don't stare or anything. this cream just seems so severe. I just have a tendency to wonder how much is just selling me stuff and how much is medicine I really need. The possible side effects of this stuff scare me!

[lunacycles]

Maybe it's time for a 2nd opinion?
I've seen at least 4 dermatologists and each is very different in their approach to skin cancer management/treatment...
Good luck, Brandi!

[Brandi]

I, too, am very fair and had multiple sun burns as a child and teen. Now I use sunblock whenever I am outside. I have had several procedures to remove basal cell cancers from various areas of this aging body! I used to go to a dermatologist, but he would "biopsy" the lesion and then have me come back a second time to remove whatever it was. Ridiculous. I started going to a wonderful surgeon. He looks at them, decides if they can be treated topically and, if not, excises them with a local anesthesia. Biopsy and removal in one step. I have used Aldara once on a lesion on my jaw and it worked very well. Yes, I got an ugly thing but it took away the lesion for good.

Presently, I am using Efudex (5-FU) cream on a lesion on my hand. After week or so of 2x daily use, it makes a raw area and then it heals and the lesion is gone.

I have a wonderful DH, who also happens to be a retired oncologist, so he watches out for any changes in moles, lesions, or whatever, that I have on me. If he recommends a removal, as opposed to the Efudex cream, then I go visit the surgeon and he takes it off.
efudex is the same stuff he wants me to use just a different name. I am using it on my chest so You say raw? raw like you have been skinned? Since this is on my chest area will it be weepy? Should I buy black t-shirts.

[AnnieBikes]

The "raw" area looks like you have given yourself a scrape. It will weep a little, but not alot, unless it is a big area. My hand spot is about 1 cm. across. It is noticeable, but not very! ..and when it heals up, there is no scar at all. It will be gone. So use it and get rid of the thing! It is not a bad treatment and it cures the basal cell CA. Good luck. Let me know if it works for you!

[Brandi]

I wish I could say it was one spot he wants me to apply it to my chest area. I will let you know how it goes. :D