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Fluorouracil (flor-oh-ura-sil) is a chemotherapy drug administered either intravenously (IV) or topically as creams or solutions such as Carac and Efudex to treat certain forms of solid tumor cancer.
Interfere with the building blocks of DNA to prevent cancer cells from proliferating and multiplying, acting as an effective cancer therapy and treating eyelid squamous carcinoma. Also available as eye drops.
Stages of Fluorouracil Treatment
Fluorouracil (5-FU), a topical chemotherapy, combats skin cancer and precancerous lesions. Treatment stages include:
- Erythema: Initial, skin reddens.
- Vesiculation: Second, small blisters form.
- Desquamation: Third, skin peels and flakes.
- Erosion: Fourth, open sores appear.
- Reepithelialization: Final, new cells regenerate, replacing damaged ones.
Duration varies by individual and condition severity. Erosion surfaces around 3rd or 4th week. Treatment lasts 2-4 weeks. Afterward, skin swiftly heals, new skin replaces sun-damaged areas in 2-3 weeks. Pre-prescription, share outcome photos. Consider patient commitments for field therapy scheduling.
Stage 1
At this stage, you apply fluorouracil cream or solution twice daily to sun-damaged areas of your skin. As part of its normal process, this may cause them to turn red, scaly and itchy; this is normal and will gradually go away over time.
Your doctor may ask you to wear sunscreen throughout your treatment course.
An infusion pump equipped with a thin short tube (cannula) administers continuous streams of the drug into your body through a cannula, with regular changes made by nurses at scheduled hospital visits to perform blood tests.
You will have fluorouracil treatment in cycles lasting several weeks depending on the type of cancer being treated; some may require only weekly cycles while others require 2, 3 or 4 week cycles; in certain instances your doctor may use fluorouracil in combination with other drugs to combat your condition such as tretinoin cream to increase fluorouracil’s effects by peeling away layers of skin) or platinum-based chemotherapy chemotherapy treatments like platinum-based chemotherapy therapy to fight cancerous growths in cells that arise as part of chemotherapy chemotherapy therapies such as platinum-based chemotherapy treatments to enhance its efficacy against cancerous growths.
Stage 2
Topical Fluorouracil or imiquimod can help prevent the recurrence of precancerous skin lesions known as Actinic Keratosis (AK), and improve long-term outcomes for patients diagnosed with Skin Cancer Cells of the Epidermis (Bowen’s disease).
Fluorouracil disrupts the building blocks that cancer cells require for growth and division, stopping their DNA from replicating itself – ultimately leading to their demise.
Fluorouracil may be part of a combination chemotherapy treatment plan depending on your medical history and type of cancer diagnosis.
Before beginning chemotherapy, your levels of the enzyme dihydropyrimidine dehydrogenase will be tested to help avoid serious side effects. Fluorouracil may be administered every week through a thin short tube (cannula), continuously through a pump carried in your arm, or as tablets.
Stage 3
Fluorouracil (5-FU), an anticancer drug that targets rapidly proliferating cells such as cancerous ones, is used to treat actinic keratoses caused by sun exposure as well as superficial basal cell carcinoma, when traditional treatments cannot. Its effectiveness has been established.
5FU enters cells where it is then phosphorylated to produce fluorouridine triphosphate which interferes with DNA synthesis, damaging cells while simultaneously inhibiting thymidylate synthase, depleting intracellular levels of reduced folates necessary for its synthesis. This process damages DNA itself as well.
A recent randomized trial revealed that administering topical fluoracil prior to cryosurgery significantly enhanced long-term outcomes; however, its use was associated with severe toxicity; most often gastroesophageal. Cerebral demyelination has been reported in one patient; other side effects included hepatotoxicity and leukopenia.
Patients may require regular blood tests for this treatment and your doctor will provide your individual treatment plan; its duration will depend upon your cancer type – you could receive sessions weekly, biweekly or quarterly depending on its nature and intensity.
Stage 4
Fluorouracil can help treat skin cancer such as actinic keratosis and basal cell carcinoma (BCC), while also serving as the initial therapy for head-and-neck squamous cell cancer that has spread or returned post-surgery. When used topically, fluorouracil stops DNA and RNA from building within cells to kill precancerous or cancerous ones – killing both precancerous and cancerous ones.
Used on its own or combined with platinum-based chemotherapy as the initial therapy it may even treat skin cancer such as actinic keratosis or basal cell carcinoma (BCC). It serves as both acts as first line treatments against spreading or returning head and neck squamous cell cancer which has spread since surgery or return after initial treatment or surgery has occurred.
Before beginning treatment with 5FU chemotherapy medicines, your blood will be tested for dihydropyrimidine dehydrogenase (DPD). Low DPD levels may make certain chemotherapy medicines unavailable – including those containing 5FU that could potentially cause serious or life-threatening side effects – so a blood test must be taken first to check it. Your physician, nurse or pharmacist will discuss this matter further with you.
Fluorouracil can be given intravenously via an IV cannula into your vein for 24 to 46 hours as a continuous infusion, sometimes in combination with leucovorin for improved cancer-fighting properties. As an oral pill known as capecitabine (Xeloda).
How Long Does Each Stage of Fluorouracil Treatment Last
The duration of each stage varies based on the individual and condition severity. Here are general timelines:
- Erythema: First stage, redness. Typically, a few initial weeks.
- Vesiculation: Second stage, blisters. Generally, 2-4 weeks.
- Desquamation: Third stage, peeling. Follows vesiculation, lasting weeks.
- Erosion: Fourth stage, sores. Often, around 3rd or 4th week.
- Reepithelialization: Final stage, new cells regrow. After erosion, takes 2-3 weeks.
Note that stage durations differ by individual and condition severity. Treatment spans 2-4 weeks. Post-treatment, skin heals promptly; new skin replaces sun-damaged areas in 2-3 weeks.
What Are the Common Side Effects of Fluorouracil Treatment
Fluorouracil (5-FU) is a topical chemotherapy medication for skin cancer and precancerous skin lesions. Like all medications, treatment may lead to side effects. Here are common ones:
- Burning, crusting, redness, discoloration, irritation, pain, itching, rash, or soreness at the site of application
- Increased infection risk
- Paleness and breathlessness
- Increased bleeding and bruising risk
- Diarrhea
- Nausea or vomiting
- Mouth sores
- Dry or cracked skin
- Slow wound healing
- Black, tarry stools
- Cough or hoarseness, along with fever or chills
- Fever or chills
- Lower back or side pain, with fever or chills
- Painful or difficult urination, with fever or chills
- Stomach/abdominal pain
- Bloody diarrhea
- Vomiting
- Signs of infection (like persistent sore throat, fever, chills)
- Easy bruising/bleeding
Not everyone experiences these effects; some may have different ones. If you encounter any of these or other unusual symptoms, contact your doctor promptly.
How Often Should Fluorouracil Cream Be Applied During Treatment
For effective treatment, apply fluorouracil cream twice daily. Ensure ample coverage of the affected area. Treatment typically spans 2-4 weeks, extendable to 6 weeks.
In certain cases, it may last 10-12 weeks to obliterate lesions. Use until the inflammatory response reaches the erosion stage, then cease. Note that dosing and treatment duration vary by individual and condition severity, under a doctor’s guidance.
