It's normal to feel a little nervous and anxious when your doctor prescribes you a 'chemo cream' as a treatment for skin cancer. When we hear the word "chemotherapy," we think of drugs that are injected into the body. But don't be afraid. This is about one such drug, a cream called Fluorouracil, or 5-FU. Let's talk very simply about how to use it and what you need to be careful about.
What kind of medicine is this?
Simply put, Fluorouracil is a type of chemotherapy drug that is applied only to the surface of the skin. It works by killing skin cancer cells or abnormal cells that may become cancerous. This means that it only works where the medicine is applied, rather than affecting the entire body like chemotherapy given intravenously.
Your doctor may prescribe this under a brand name like `Carac`, `Efudex`, `Fluoroplex`, or `Tolak`. They are all the same type of medication.
Things you need to tell your doctor before using the medicine
It is very important to clearly tell your doctor about these things before you start using this medicine.
- If you have an enzyme deficiency called dihydropyrimidine dehydrogenase (DPD) deficiency . This is a very rare genetic condition. People with this condition can experience severe side effects if they take this medicine. Therefore, you should inform your doctor about this.
- If you have allergies to fluorouracil, other chemotherapy drugs, other medications, foods, dyes, or preservatives.
- If you are pregnant, trying to get pregnant, or breastfeeding , this is very important.
- Tell your doctor about any other medications, vitamins, and traditional medicines you are taking.
How exactly do you use this?
To get the most out of this medicine, it is essential to use it correctly.
1. Wash your hands: Be sure to wash your hands thoroughly with soap before and after applying the medicine.
2. Clean the area: Gently wash the area of skin where the medicine is to be applied with lukewarm water, pat dry with a clean cloth. Do not rub vigorously.
3. Apply the medicine: It is best to use a cotton bud to apply the medicine. Or, apply it with a gloved finger.
4. If you are applying the medicine with your finger: If you are applying the medicine with your finger without gloves, wash your hands very well with soap and water again as soon as you are finished. This is very important.
5. Be careful: Do not let this medicine get on sensitive areas like the eyes, nose, or mouth.
6. Apply a thin layer: Apply a thin layer of the medicine to cover the area prescribed by the doctor. You don't need to apply a lot.
7. Covering: After applying the medicine, you can cover the area with a light piece of gauze. But never cover it with air-tight dressings like plasters .
Continue this treatment for the full duration prescribed by your doctor. Even if your skin seems to be improving, do not stop without medical advice.
Things to be careful about when using the medicine
Changes in skin appearance
During and for a few weeks after the treatment, the treated area may look very uncomfortable . This means that the area may become red, sore, or flaky. This is normal and means that the treatment is working. So don't worry. It may take a month or two for the skin to fully heal after stopping the treatment.
Protect yourself from the sun.
When using this medicine, your skin becomes very sensitive to the sun (photosensitive). Therefore,
- Avoid going out in the sun as much as possible.
- If you must go out in the sun, cover your skin with long-sleeved clothing, hats, and use a good sunscreen .
- Do not use sun lamps or tanning booths.
Be careful with pets (very important!)
This is a very dangerous matter. This cream is very dangerous and can be fatal to your pets (dogs, cats). If an animal licks an area where this cream has been applied, or if it puts the tube of cream in its mouth, it is life-threatening.
- Wash your hands thoroughly after applying the medicine.
- Do not let your pet touch the treated skin.
- Be careful not to let the medicine get on clothes, carpets, or furniture.
- If you absolutely cannot avoid contact with your pet, ask your doctor if you can cover the treated area.
What side effects can occur?
Some side effects caused by this medication are normal, but there are some things you should be aware of.
| Side effects and what to do | |
|---|---|
| If you experience these symptoms, call your doctor immediately. | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips or tongue. |
| Symptoms affecting the whole body | Bloody diarrhea, fever or chills, severe stomach pain, vomiting. (These are rare but serious). |
| Symptoms that are common, but should be reported to the doctor if they persist | |
| Differences in the dosage of the medicine | Skin redness, dryness, inflammation, itching, peeling of the skin. (These may be signs that the medicine is working). |
| Sun sensitivity | Skin that turns red or burns quickly when exposed to the sun. |
More things to know
- What if I miss a dose? Take the medicine as soon as I remember. But if it's almost time for my next dose, skip the missed dose and take the next dose at the scheduled time. Never take a double dose.
- What if you take too much medicine? If you think you have taken too much medicine, or if someone (especially a child) has swallowed it, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the ETU (Emergency Treatment Unit) of the nearest hospital.
- How to store? Keep out of reach of children and pets . Store according to package directions. Throw away expired medicine.
Take-Home Message
- Fluorouracil (5-FU) is a chemotherapy cream that is applied to the skin only and is used to treat skin cancer and precancerous lesions. Use it exactly as your doctor tells you.
- It is normal for the skin to become red, inflamed, sore, and flaky during treatment. This is a sign that the medicine is working. So don't worry.
- It is essential to protect yourself from the sun when using this medicine. Wear well-fitting clothing and use sunscreen.
- Extremely important: Keep this medicine completely away from your pets (dogs, cats). It can be fatal to them.
- If you experience serious side effects such as fever, bloody diarrhea, or severe allergic reactions, see your doctor immediately.
- Complete the treatment for the full duration prescribed by the doctor. Do not stop halfway.
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