What is a "topical chemotherapy" and is it effective in treating skin cancer?

What is a "topical chemotherapy" and is it effective in treating skin cancer?

Harry Saperstein, MD, FAAD (Dermatologist, Clinical Assoc. Professor, Medicine, Private Practice and UCLA) gives expert video advice on: How are early-stage melanoma skin cancers treated?; What types of radiation therapy are used to treat skin cancer?; Does laser therapy have a role in treating skin cancer? and more...

In very superficial basal cell carcinomas and in superficial squamous cell carcinomas, we do have an ability to, on occasion, treat with a topical agent which can destroy the tumour cells. There are two topical agents that are used. One is 5% 5-Fluorouracil. 5% 5-Fluorouracil kills the cancer cells as they divide. Its limitation is it works topically, and so only superficially. It is nowhere near as effective as using surgery to remove the lesion, but it of course is non-surgical, so there's less bleeding, etc. However, it is a long treatment option. You have to use it for a period of time. The second alternative, which is relatively new, is Aldara, or Imiquimod. This is a medication which is an immune stimulant. Any time there is a cancer of any kind, there are two components to the cancer. One is the cells have to be abnormal, and two is they have to camouflage themselves from the body's own immune system. What Aldara does is it brings the body's immune system over to the area to offset that camouflage, and as a result, the immune system very selectively will destroy the cancer cells. This is a long, drawn out procedure, whereby the Aldara has to be put on once twice a day for sometimes as much as twelve weeks. It causes a fair amount of inflammation, irritation, crusting, and oozing, and the cosmetic result can range anywhere from very good to average. It is of some value for those patients who do not have the capability of surgery, or patients who have multiple lesions at any given time.