Little known topical ways to prevent and treat skin cancer

Question:  My dermatologist gave me a topical cream with special ingredients to prevent skin cancer where he thought it might be forming. How is that even possible?

Answer:  It is now possible and FDA-approved.  There are some new topical medications that target different mechanisms to halt cancer cells from growing.

5-fluorouracil (5-FU):  This long-standing chemotherapy drug has been used internally and is also now FDA-approved for use on top of the skin to prevent and treat superficial Basal Cell Carcinoma (BCC). It is the active ingredient in proprietary topical skin cancer prevention formularies and several prescription creams with 5-FU or related medications available by prescription.

When applied on the skin topically, 5-FU selectively targets and destroys only cancerous or precancerous skin cells damaged by sun and aging while leaving normal skin cells alone. It’s something you can use at home, under a doctor’s supervision, on many parts of the body  such as chest, neck, hands, legs and back.

A course of treatment usually lasts approximately 14 days.  After several days of initial application,  the appearance of redness, scaling, and eventually crusting occurs on treated areas and indicates that precancerous cells are dying; how soon they appear and their severity depends on the strength of the 5-FU product and how often it is applied. The end result is a healthier looking, more attractive skin with a reduced tendency to develop skin cancer.

Imiquimod:  This cream is FDA-approved to treat superficial BCC’s that works by stimulating the immune system and causing the body to produce interferon, a chemical that attacks cancerous cells. The cream is rubbed in the  the lesion 5 times a week for 6-8 weeks (sometimes longer).  This treatment can also produce some discomfort, redness, irritation and inflammation.

Cure rates for both are 80-90 percent because they kill active cancerous or precancerous cells over time instead of all-at-once.

Never self-diagnose or try to use these medications without a doctor’s supervision, as in the rare case a BCC is locally advanced or  metastasizes (spreads), the cancer can become dangerous, even life-threatening.

Have you tried 5-FU or any of the topical skin cancer prevention treatments?

 

 

 

 

 

 

 

 

 

 

See how simple a Basal Cell Carcinoma removal can be

Question: My dermatologist said my scab was a Basal Cell Carcinoma…Now what? Do I have cancer?

Answer:  Relax. A Basal Cell Carcinoma (BCC) is rarely the spreading cancer that requires the systemic chemotherapy you’re thinking of. Cure rates for BCCs are close to 100 percent, and are easily treated when caught early.

After having your skin examined, the diagnosis of BCC is confirmed by biopsy, which is when the skin is numbed with a local anesthetic and a sample of your lesion is removed and sent to be a lab for examination under a microscope. If tumor cells are present, treatment is required.  BBCs rarely spread beyond the original tumor site so we simply remove them by  any number of methods depending on the type, size, location and depth of the tumor as well as your age and general health. Since BCCs are visible on the surface of the skin, we also take the likely outcome to your appearance into consideration.

Usually, treatment is performed on an outpatient basis in a dermatology office.

A local anesthetic is almost always used so pain during the procedure is minimal, although you may have some mild discomfort afterwards.  After removing a small BCC, wounds heal and the scars are usually cosmetically acceptable (and there are many other methods or repairing  or improving any resulting damage that is undesirable to you).

The types of treatment include:

  • Curettage and electrodesiccation: The growth is scraped off with a sharp, ring-shaped instrument (called a curette), and the tumor is dried out (dessicated) and destroyed with an electrocautery needle. The procedure is often repeated during the same procedure to ensure that all the cancer cells are eradicated. It has a 95 percent success rate for smaller lesions (and often for the first biopsy), although often not useful for aggressive BCCs or in those sites that where any scarring would be highly undesirable as sometimes a white scar is left at the surgical site.
  • Mohs Micrographic Surgery:  A physician specially-trained in Mohs Micrographic Surgery removes a thin layer of tissue containing the cancer and while the patient waits, the frozen previously removed sections are examined under a microscope by the Mohs surgeon. If skin cancer is still present in any of the tissue, the procedure is repeated only on the area where those cancer cells were identified, until the last layer is cancer-free. This technique saves a great amount of healthy tissue and has a high cure rate of 99 percent or better. It is often used in cosmetically important or large, critical areas and in those areas that have recurred, are hard to pinpoint or in critical areas  with little tissue to spare such as around the eyes, nose, lips and ears.
  • Excision surgery: We use a scalpel to remove the entire growth along with a surrounding border of apparently normal skin (called a safety margin) and then the site is closed with stitches.  A specimen is sent to the laboratory for microscopic examination to verify that all cancerous cells have been removed. Although cure rates are above 95 percent, if the tissue analysis shows cancer cells at the margin of tumor, a repeat excision may be necessary.
  • Radiation: X-ray radiation may be used in tumors that are hard to manage surgically, elderly patients or other patients in poor health. The radiation is directed at the tumor, with no need for cutting or anesthesia and total destruction usually requires several treatments a week for a few weeks. Cure rates are around 90% because the technique is not precise in identifying and removing cancer remaining at the margins of the tumor
  • Cryosurgery:  While not often used, sometimes we can destroy very superficial BCCs  by applying liquid nitrogen  to the growth with a Q-tip or a spray to freeze it, which also does not require cutting or anesthesia. After the treatment, it may be blistered,  crusty and fall off within weeks and the procedure can be repeated.
  • Erivedge™ (vismodegib): The first oral medication approved by the FDA for the treatment of  advanced BCC which is used for the limited circumstance where the nature of the cancer prevents the use of other treatment options. (Should not be used in woman who are pregnant or child-bearing.)
  • Topical medications: Certain prescription topical creams, gels and solutions are FDA-approved  to treat limited specific BCCs and some are used to prevent possible BCCs from growing.

The best treatment for BCCs is prevention:  Always wear sunscreen of SPF 30 or higher on exposed skin exposed and wear a hat whenever possible!

What’s your story about BCCs?

 

 

 

Are you at risk for this common spot for skin cancer?

Question: My hair has been thinning considerably for several years now, and my hairdresser recently found some  strange spots on my scalp. What are they?

Answer: Watch out for basal cell carcinoma (BCC), the most common, treatable form of skin cancer, on your scalp, especially if you are balding or your hair is noticeably thinning.

Think about it:  The top of your head, forehead (and also your nose) is exposed to the sun’s harmful rays more than any other part of the body. Once you lose the cover of your thicker hair, your scalp is highly vulnerable.

The tricky thing about BCCs is that those who have had one BCC are at an increased risk for developing more tumors later  in the same area or elsewhere on the body and you may also be at risk for other types of skin cancer. And the recurrence of scalp BCCs is even higher within the first two years after surgery because of the constant sun exposure.

No matter where you (or someone else) notices any type of strange lesion (there are 5 warning signs of a BCC), check in with a dermatologic practitioner regularly so your entire skin surface can be examined, especially in places like the top of your head that you cannot easily see yourself...and wear a hat!

Has anyone else ever found strange spots on you? What did they turn out to be?