Just finished Efudix

Hello Sprinkle,

I have no medical qualifications whatsoever but I have used Efudix on three occasions and also had several BCCs and two SCCs,  

In my opinion, you need have no concerns.  Efudix is a tried and tested cream which is highly effective against sun damaged skin and various pre-cancers,  Its performance on tackling fully developed skin cancers is less clearcut - the smaller and less-developed the cancer the better chance it has of being successful.  Unfortunately there comes a point when the cancer is sufficiently deep that the cream cannot penetrate and destroy the cells.

Your Consultant obviously thought that the Efudix had a reasonable chance of destroying the BCC without the need for surgery.  Now, having completed the treatment, only two outcomes seem possible to me.  Firstly the cream has been successful and, other than keeping an eye on the area, no other action will be necessary . Secondly the cream has failed to remove all cancer cells in which case, I feel, the consultant is likely to recommend surgical excision. The Efudix will have helped to define the area far more clearly than by the naked eye alone.  Either way, you can relax in the knowledge that your consultation is only a month away and nothing of significance will happen in those four weeks. The Efudix will either have done the job or been a useful step to getting the job done.

There is no need to worry about going beyond the perimeter of the cancer or about applying too thickly.  No harm at all will have been done in either case. At worst, you may have experienced a little more discomfort than necessary and, at best, the cream may have destroyed some pre-cancerous cells on the fringes of the cancer.  It is my understanding that Efudix does not 'attack' healthy skin.

The fact that you have had a strong reaction to the cream is a good sign - its done its work!

Good luck and best wishes,  Bill

Hi Bill, thank you so much for taking the time and trouble to send me such a thoughtful message.  It is so appreciated. I am extremely sorry to hear that you've had to use Efudix several times but you sound upbeat, very informed and from what I've read here, like you, many people will have to use it more than once and will forever remain vigilant. Maybe your story is here?  If so, my apologies for not having read it.

I mentioned the mark on my nose to the doctor in passing as I had gone to see them about something else and in a way, although this is, undoubtedly, a very serious matter, I take heart that it is treatable and am now informed so will now notice any little mark and take action. Although I was actively kept out of the sun as a child and teenager, have never sunbathed and tried to protect my skin, I am very fair and, obviously, any sun has been too much.  

I very much hope that you're fine at the moment and given your own experience it is so helpful to have your support and wise words. That's so kind.  My nose is now very red in both places, still, but it looks as if there is more crusting happening on the side and the tip is raw and red, a bit crusty, but no bump.  Hopefully good news.  I am blessed that I have incredible medical help and now that I've found supportive words here I will post with my updates in the hope that it may help someone else who has felt desperately worried and a bit lost and at the start of this unwanted journey. Thank you again.

Hi sprinkle

I've had a basal cell removed from my nose and I've also used effudex.

My skin became red, crusty, broken and sore but one the effects had worn off and the redness went I was left with health looking skin.

Don't get get disheartened as your skin will heal. It just takes time 

Thank you Puckettyboo for your supportive words.  It means so much.  Looks like my nose is crusting yet again today.  It's just lovely knowing that others are kind enough to offer to support and sharing their own experiences.

Hi.  I had the experience of treating BCC using Efudex on my lip. I did not get the tumor cured with this cream in the end.  And I ended up having it surgically removed after 6 months. But, now it has relapsed already after surgery.

 When I was treated with Efudex, the inflammation went all over my upper lip and nose—swelling, pain, crusting, and feeling terrible. My surgeon doctor explained it to me this way, efudex is not a targeted drug and it destroys both healthy and tumor cells. And that most of those who have been treated with efudex end up going to surgeons anyway.

There are also those who have been successfully treated with efudex and there is still hope for a successful result. I highly recommend you observe the skin of your nose after the treatment and after two or three months, make sure that you have a second medical check-up to see if everything is normal. After all, the nose requires special attention. And you need to be checked regularly.

I don't want to upset you, but I don't understand the enthusiastic words about Efudex either, somebody has to warn you.

Hi Stephi

Thank you for. your response and I am so sorry to hear of your ordeal and that Efudex has not, in the long run, helped you and that you have now had a relapse.  

I am at the start of this journey and have tried to stay positive, but today was feeling very down and scared anyway, so while I respect your honesty, I have to admit I am fretting even more now! I don't know what's going to happen but for the moment can only hope that Efudex does help me.  Your advice about  getting regular checks is so wise - thank you for this - and I intend to do so.  The first step is seeing the Consultant again in around three weeks and see what state my nose is in and whether any further treatment is required at the moment.  I realise that this issue is probably going to be with me for the rest of my life and although that's a not nice prospect at all, at least I will be on red alert for anything untoward.

I very much hope your BCC will be treated and got rid of quickly.  Thank you for taking the time to share your experiences and again, I'm very sorry that you've had such a rough time. 

Hello Sprinkle (and Stephi),

I hope you'll forgive me, but I feel I must respond to some of the points made by Stephi.

Firstly, and importantly, I am so sorry to hear of the rough time that Stephi has had and send my very best wishes for a successful and speedy end to this difficult period. The very best to you.

I have re-read my original posting and am happy with every line. I did think carefully before tapping the keyboard and updated research I had undertaken some years ago. It was not, and is not, my intention to be "enthusiastic" (or indeed, unenthusiastic) about Efudix (or Efudex, depending where in the world you live) but to try to be as dispassionate and balanced as possible.  I've no wish to repeat my earlier lines but I did state the cream's less than clearcut record of success in tackling fully developed cancers compared to its record on pre-cancers.

Clearly any medication has its successes and failures, I'm sure there are many who have tried Efudix with no success. But it is important, I feel, to take a balanced, evidence-based view.  Efudix was first used in 1962 and over the last six decades has been used by millions of patients in hundreds of countries.  Despite the development of many excellent alternatives, it remains a popular, and sometimes first, choice of dermatologists and skin cancer specialists.  They have their reasons, I'm sure.  It has truly stood the test of time.

I'm baffled by the assertion that the cream is non-discriminatory.  This runs counter to everything I have read, One example - in the UK every medication has to be accompanied by a Patient Information Leaflet.  All contents need to be thoroughly checked and independently and scientifically verified.  Moreover, it has to be revised every few years as more evidence is gathered from the field.  In the relevant leaflet one of the very first lines is "Efudix destroys cancerous and precancerous cells while having little effect on normal cells".  Surely the fact that neighbouring skin reacts strongly to the cream is a sign that the Efudix is attacking precancerous cells,and not that it is attacking healthy, unaffected skin?  It would, after all, be miraculous, if the Sun's rays had been so damaging as to produce a cancer and not damaged adjacent skin at all.

I'm sorry to write at such length but it is obvious that you (Sprinkle) are feeling very stressed and worried and I want to do my best to reassure you that it seems to me you are in good hands, you have followed the specialists advice in pursuing an eminently sensible line of treatment and that, so far, everything is as it should be.  As I wrote earlier the cream will either work by itself (great!) or it will be a huge help in any subsequent surgery (helping to define the extent and characteristics of the cancer and therefore what margins should be taken and so forth).  After this episode you will be so much better armed to catch any similar problems early.

Good luck and I promise I'll try very hard not to write again! 

Very best wishes, Bill

Sprinkle, thank you for your wishes. Unfortunately, BCC is not as easy to cure as we would like it to be.  In your case, I wouldn't worry about it just yet. But the nasal skin needs to be monitored and checked. That Efudex was able to cope with the cancer cells, there is a chance. And if it doesn't, most of the tumor as a crust will fall off anyway, and the remaining tumor can be treated by other methods.Most people are cured that way.

Thanks, Bill for your good wishes. Prescribing Efudex with an information leaflet attached to it, I think that is not enough. There is a great lack of detailed explanations from the doctors, what to expect, what side effects to encounter, and what the results might be. Doctors don't want to spend a lot of time talking to patients.

As my surgeon told me, treatment with Efudex is external chemotherapy, the cream penetrates into the organism very quickly. When I used Efudex, after 3 weeks I developed gastritis and intolerance to certain foods and associated diarrhea. The surgeon told me it was because of the cream. I haven't used the cream in over a year and gastritis still bothers me, which I never had before in my life. But it was not even the efudex, but the doctor, who did not explain anything to me and was stingy with words, just a nice smile.

Two months after efudex, I had a revaccination for covid. The surgeon told me that the revaccination might not be effective. That the revaccination should have been done either 2 months before applying efudex or six months later. Neither the GP nor the dermatologist gave me any explanations about this.

Thank you Bill and Stephi for responding and I hope I have not caused any tension.  At the end of the day I won't know  for weeks as to whether Efudex has worked.  I am now left with a red smudge across all of the bridge of my nose - I had applied Efudex too enthusiastically, maybe.  I have some photos of before using it and there is still a darker mark where the spot of concern was.  So, I'm not sure whether it has, actually, worked, or whether the skin will continue to change and there is still hope.  The specific area does feel sore but no more crusting. As far as the one on the side of my nose is concerned, there isn't anything there apart from redness on the entire area where I applied the cream.  I am confused, worried, but just have to be patient now.