Efudex (Fluorouracil) Skin Cancer Treatment

[Two days after stopping Efudex treatment.]

I am thankful for quite a lot, actually.

Thankful for friends who email me with suppport, and ideas for how to cope. (see below)*

Thankful for my kids, I love them a lot and I am so proud of every one of them. (And happy 18th birthday today to my Rachel.)

Thankful for my health…besides this little skin annoyance and a few others, I really don’t have any major issues to worry about, I am in pretty good shape for a guy pushing 50.

Thankful that I was able to stop the Efudex a little early, and that after another handful of days, I can expect to start seeing improvement.

So…okay, I did wake up at 5:30 this morning with a combination of pain and itching that just about drove me out of my mind. But I got up, put on some steroid cream, and managed to fall back asleep for a few hours.

 ——

* re: Advice from a friend…I had been wishing I owned some kind of shirt that has a very large opening for one’s neck/head. because my neck is so sensitive right now that wearing any shirt is painful. A friend suggested cutting out the collar of an old tee-shirt. Excellent suggestion…did that, and have been wearing it for two days now. 

[One day after stopping Efudex treatment.]

Felt miserable last night–chills, itching, exhaustion.

Felt absolutely miserable this morning. All movement was painful. I think the forehead and arms would be quite tolerable but the neck, that is the real pain point because of how the skin has to move for me to be able to function.

I went and got the steroid cream prescription filled this morning. I did feel better shortly after applying it. I doubt the improvement was due to the steroid, I think I would have had the same improvement from Aquaphor. (Of course in the long run, the steroid will be a better aid to healing.)

The elation of learning that I can stop the cream has faded slightly, although I am still very pleased about that.

The reality is that I am still itching a lot and it is still painful to wear a shirt.

And from reviewing one of the other online logs, I am reminded that upon cessation of the medicine, the skin condition can continue to worsen for a week or so before it starts to get better.

Still…of course today is a major milestone and I am happy. Just facing the fact that I probably have two weeks or so to go before I feel relatively normal, and another week or two after that before the visible signs of this experience have faded.

But…it’s all good. Lots of precancers just got obliterated before they even had a chance.

Last night, I had some rather serious itching, mostly on my forehead but also on my arms.

This morning, I woke up with a severe sharp headache, and neck skin that was oozing and dry and tight and painful.

But that isn’t the big news for today…

I have been on a twice a day for three weeks regimen of Efudex. This morning’s treatment was number 30, completing 15 of the planned 21 days.

But yesterday, I shared my pictures with mom and dad, who have also used Efudex, and they suggested that maybe I have gone far enough, and perhaps I should see my dermatologist now, to see if another six days would be more pain for no gain.

So, this morning, I saw Dr. Sasson.

“This is good! You are having a good reaction. This is what we want.  . . . You can stop now, if you want. Or, stop on the neck and continue with the arms.”

So I said, “I can stop, but what should I do? What do you recommend?” And I heard angels singing as he said:

“If it were me, I would stop now. You have done enough.”

With a wave of his pen, I had a script for Triamcinolone Ointment, a steroid which he said would speed the healing, and I was headed for the door… Stopping at the receptionist’s window, I was informed that I had a $20 co-pay for the visit. That may just have been the best twenty bucks I even spent.

I love you, mom and dad, and thanks for the advice.

And Dr. Sasson….I love you, too.

No more brave words about how this is just “unpleasant.”

Nope. Have to admit, it hurts. I had difficulty driving this morning, because my neck was so painful that I could barely turn my head.  It is a little better now…perhaps that is because of the Efudex cream itself, which I applied after my drive to the pharmacy.

This morning  was the 28th application…it is taking longer now because the skin is so tender, it hurts to spread the cream. But 28….that is twice a day for two weeks…a minor milestone. One more week and the cream stops. I know the battle isn’t over then, but I think I will have more options for treating the symptoms.

Are we having fun yet?

I feel the itching and the burning…my hands and arms are mostly just itching, but my neck is itching and burning. It hurts to turn my head to the side, becauase the skin on my neck is so dry, raw, and tight. 

Even my forehead hurts.

Yep, I am definitely having a good time.

Another day in the books…that is what I am focused on right now. It has been advised that while going through Efudex treatment, one should focus on the calendar and not the mirror. And truly, I am not disturbed by my appearance–although you may be ;)  I just need to get through this.

So, today was not pleasant, nor was it a nightmare….but it is a day that has come and gone, and right now, that is a happy enough thought.

It has been a difficult day. I feel exhausted and a little sick to my stomach (neither of which may have anything to do with the Efudex.)

My arms are worse, my neck is worse. I have been getting the chills a lot today, similar to the chills one gets from a bad sunburn. It is an unseasonably cool day, but I am running my space heater in my bedroom/office so I can be comfortable with a minimum of clothing.

I did buy some Aquafor tonight and will put it on before I go to bed. I have seen that highly recommended (as better than vaseline) by other Efudex users.

I had a hard time sleeping last night. I wasn’t comfortable on my back because of my neck, but I couldn’t sleep on my stomach because I can’t turn my head to the side. I tried to get comfortable sleeping on my side but that was a problem too.

Also, I was irritated by the sheets rubbing against my arms. I think a long-sleeved shirt at night will help with the arms…as long as it doesn’t get too hot.

Since I am doing a three-week course of two-a-day applications of Efudex…tonight’s aplication marks the halfway point of the creme. Twenty-one down, twenty-one to go.

I am glad for that, because it has become an unpleasant process, applying the creme. It doesn’t burn, but it does irritate the raw skin. It is not soothing.

The reason I say “sort of halfway” is that of course the effects of the cream lag behind by about a week. So, the cream is half done but the overall experience is definitely not at the halfway point yet. (My understanding is that the redness/rawness/etc. does not beging to improve until about a week after the cream is stopped.) 

I had more itching today, on my arms, plus a little itching on parts of my neck.

My skin continues to worsen. It is difficult to drive, because I cannot turn my head without some pain, due to the dryness and tightness of the skin on the sides and back of my neck.

Still…I think the words “unpleasant” and “uncomfortable” are accurate…if I said I was “suffering,” while literally true, I think that would be an overstatement at this point. There is plenty of time for suffering later.