Topical treatment for multiple Squamous Cell Carcinomas

[MikeOr]

It is clear from the previous posts that quite a few of the CLL patients here developed multiple Squamous Cell Carcinomas, often requiring several surgeries per year. Have anybody of you tried any topical treatments, like 5-fluorouracil or Diclofenac ? If yes, were they successful in your case ?

[GMa27]

Dermatologist wanted me to use Floru as a preventative measure but I didn't like the ingredients. As far as my squamous- I definitely wanted Mohs to be sure it was gone. He didn't suggest anything else to try.

[Vizilo]

Unfortunately, skin cancer seems to go hand in with cll for a large number of us. As my dermatologist has pointed out, it does not help if you were exposed to more UV than necessary in your younger years.

In addition to a number of squamous cell carcinomas, we can also look forward to some basal cell ones and, in my case, a more aggressive sebaceous cell carcinoma recently.

The surest paths to controlling these carcinomas are frequent self-exams for unusual spots as well as regular visits (every 6 months or less) to your dermatologist. My dermatologist generally cuts out any suspicious growths and then sends them off for analysis. For the more aggressive skin carcinomas, she follows up with a referral to a plastic surgeon to make sure that she got all of it.

She has never suggested any meds or ointments to prevent future growths.

[Sumoldbloke]

I have been prescribed 5-fluorouracil and it did work on a lesion on the back of my hand. My experience is that it works on the skin damaged areas but less successful more established growths. It also requires regular application . My dermatologist recommended twice a day for two week rather than once a day for a month as people tend to stop once the area appears to improve. Don’t know about diclofenac.

[Pearlpink]

my dad had squamous cell cancer treated with skin graft on his head about 7 years ago and has been fine ever since 🤞.

We use fluouracil whenever he has a small eruption on his head now and it stops them developing. I think we are probably catching them at precancerous stage though. It’s known to be very good for actinic keratosis and very very early basal cell cancers. The problem with scc is that it can be very aggressive (my dad doesn’t have cll but is in his nineties now). Fluouracil can initially cause a tiny ulcer when used and I would be much more wary of using it on an scc as I don’t think I would be able to tell if it was it was the fluouracil or the scc getting worse. My dads scc started as a scab and then suddenly developed tiny ulcer under the scab.

Within a few weeks it was quite big (approx 0.75 cm) and had penetrated the top skin. Had to have two surgeries in quick succession as not enough margin of first. He healed very quickly from the skin graft and now just has a small dint.

We have found fluouracil wonderful fit stopping anything in its tracks since. Feels like getting power over it back. Haven’t had to use it for few years and we always let the dermatologist know if we think we have to use it.

I think his is age related, and genetics- his identical twin got scc on his ear a month before him.

Neither had any complications after removal.

Best wishes

[AussieNeil Administrator]

I was prescribed the less effective of the two treatments for a scabbing sore in my ear, too close to my ear canal for surgery. (I subsequently found found and shared a paper with my dermatologist on the better skin treatment). The treatment was not pleasant and was unsuccessful. During treatment for my CLL, the scabby skin healed!

[SlowCLL]

Hi Mike,

Yes, I have used fluorouracil several times for treatment of sun damaged tissue on my hands, forearms, and lower legs. And yes, it acted to eliminate or reduce the numbers of actinic keratoses (AKs), the premalignant skin lesions that left unchecked can turn into cutaneous squamous cell carcinomas (cSCCs).  Anything that reaches the cSCC status gets cut out.

Also, before fluorouracil was developed, dermatologist used earlier topical chemical treatments and light activated chemical treatments on my bald head rather than use liquid nitrogen or surgical procedures to remove AKs individually.

My regular dermatologist is now on maternity leave.  So, I will soon be starting a new fluorouracil treatment for some large crusty spots on my bald scalp and lower lip that will be supervised by another dermatologist who is a strong advocate for “Field Cancerization Therapy” (FCT).  I understand my FCT will involve the use of fluorouracil on the obvious AKs, along with the surrounding normal appearing skin that may have been exposed to similar sun damage and may contain less apparent AKs.

I had a well spent youth with a lot of time in the sun, by next summer I will turn 80 years old, my immune system no longer provides much protection against skin cancers.  I do not see fluorouracil as a cure, I am just trying to treat things with what is supposed to be the most effective topical treatment before they get worse. 

Don’t know much about Diclofenac.

Good luck with your dad,

Owen

[Vlaminck]

Knock on wood, no squamous yet, but have had intermittent actinic keratosis (precursors). Doc did suggest doing a 5FU (as it was called when it was a major chemo given to hubby for solid tumor) cream all over face to kill off whatever is lurking -- but to schedule in winter (cause burns face all over, unsightly so might be less in public in winter). I put this option off and in meantime, experimented with oregano oil (careful, this stuff BURNS skin), at different strengths to burn the AKs off (which is what docs and 5FU do). I also started taking niacinamide which doc conceded helped with these issues (I now no longer take it every night but off and on, as I currently don't have any AK that I know of -- though I have 6 mo appoint in January to make sure).