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1701 Divisadero St.,
3rd Floor
San Francisco, CA
94143-0316
 
Skin Cancer
Skin Cancer Guide
Transplant Patient Guide
Caring for Transplant Patients
Seminars
Organ Transplant Immunosuppressed High Risk Skin Cancer Clinic
Tumor Board
Mohs Surgery
Contact and Referrals
Research and Clinical Trials
Dermatology Faculty

 

Medical Treatment of Skin Cancer and Precancers:
  • Topical Field therapy
    • COX-2 inhibitors (Actinic keratosis)
    • Topical Retinoids (Actinic keratosis, superficial BCC)
    • 5-FU (Actinic keratosis, superficial BCC, SCC in-situ)
    • Effudex® or Carac®
  • Topical chemotherapy for the skin
    • Excellent choice for numerous actinic keratoses
    • Preferentially absorbed by the precancerous or cancerous cells
    • Apply 2x/day for 3-4 weeks
    • Skin turns red and crusty- like a very bad sunburn
    • Visible and sub-clinical lesions "light up"
    • Imiquimod (Actinic keratosis, superficial BCC, SCC in-situ)
  • Immune response modulator
    • Stimulates the immune system in the skin to recognize and destroy precancerous and cancerous cells
    • Cream is applied several times a week
    • Skin turns red and crusty during the course of treatment- if no reaction occurs, need to increase the frequency of application
  • Bleomycin
  • Acitretin
    • Reduces the rate at which new skin cancers appear
    • Benefit only when taking medication
    • Potential candidates: patients with >5 skin cancers /year
    • Side effects: liver toxicity, elevated cholesterol, dry skin
    • Average required dose: 25-30mg/day(13)
    • Begin with acitretin 10 mg qD then titrated upwards as tolerated
    • Side effects include but are not limited to:
      • Hyperlipidemia
      • Dry skin
      • Hepatotoxicty
  • Radiation
  • Chemotherapy(9)
  • Reduction of immunosuppression(10)
    • Consider when benefits outweigh risks
    • Potential candidates:
      • Metastatic skin cancer of any type
      • >5 to 10 skin cancers/year
      • Kaposi's Sarcoma
      • Post Transplant Lymphoproliferative Disorder
  • Consider adjusting immunosuppressive regimen
  • Switch to less carcinogenic medications (14)
Updated: May 4, 2007
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.
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