Dermatology question?

[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.