Efudex (Fluorouracil) Skin Cancer Treatment

Six years ago, I had the dubious pleasure of living with red, raw, burning, itching, cracking, scaling hands for a month.

Now, finally–I have dreaded this for years–it is time for my face to endure the same treatment.

But not only that…my forehead, the back of my neck, my hands, and my arms, up to my tee-shirt sleeve. I don’t have to do it all at once, and I may live to regret this decision, but I intend to just bite the big bullet, and get it all over with at once. Six weeks from now I will be glad I did. Three weeks from now, I may be seriously questioning my sanity.

The condition is Actinic Keratosis, and pre-cancers too numerous to treat one at a time. The treatment is Efudex (fluorouracil, also sold as Carac) cream, applied twice a day for three weeks. The side effects are nasty, and will last several weeks beyond the end of application of the cream.

I have expected this journey I am going to share with you…part of this…and to some extent, have dreaded it for years.

I owe it to my fair skin, my love of the outdoors, and the fact that I was born about 10 years before the term “SPF” and the word “sunscreen” became part of our collective summer lexicon.

When I was a boy, and my family went to the beach, it was either Coppertone or Sea & Ski.  Of course my parents knew that sunburns could be painful, and did their best to take care of my siblings and me in that regard….but the damage was done.

Fast forward to my early thirties…during those years, I lost two friends, John and Joe, to malignant melanoma, both leaving wives and sons. I began making somewhat regular visits to the dermatologist, and started learning about skin cancer.

Fast forward again, to my early forties. I had been a somewhat regular patient in my dermatologist’s office for about ten years, and nearly every visit had resulted in several new “spots” being either frozen off or cut off and biopsied. Most of those spots were benign, quite a few were basal cell, and two were squamous cell.

On one of those visits, my dermatologist gave me a prescription for Efudex and asked me to put it on the backs of my hands twice a day for three weeks. He explained that Efudex was a topical chemotherapy, and that it would “kill” many, many pre-cancerous spots before they could progress to the point that they had to be surgically removed.

In concept is sounds great. In practice, “it isn’t hell but you can see hell from there.”

I did my research. I learned that Efudex is brand name for fluorouracil, sometime referred to as 5-FU; another brand name is Carac. Technically these drugs are in fact chemotherapy, but they won’t make you nauseous or cause you to lose you hair. What they will do is make the treated area of your skin look and feel completely miserable for several weeks. 

And that, in fact, was my experience, with my hands.

I have switched to a new dermatologist, and he has recommended that between now and my next visit six months from now, I treat the back of my hands again, but also my forehead, the back of my neck, and my arms, from my wrists to a few inches above my elbows.

Given my apparent love for beating myself up, I am going to do it all at once, and get it over with.