Results from a
clinical trial which involved over 900 veterans who were at high risk for skin
cancer showed that using a generic skin cream reduced the risk of the cancer.
- Clinical trial results show promising evidence that use of fluorouracil 5% (5-FU) reduces risk for
keratinocyte carcinoma skin cancer.
- Usage of the skin
cream for just one month offers continued protection and risk reduction
for up to one year.
- A statistically
significant 75 percent risk reduction was observed in high risk
individuals who were given 5-FU compared to those who received placebo.
The generic skin cream called fluorouracil 5 percent (5-FU), when used for a period of one
month reduces the risk of a squamous cell carcinoma (SCC) by 75 percent within
; SCC is a cancer that would
otherwise need surgery. This would mean that just using the cream for one month
appears to prevent cancer for up to a year, said lead author Dr. Martin A.
Weinstock, a professor of dermatology in the Warren Alpert Medical School of
Brown University and chief of dermatology at the Providence Veterans Affairs
Medical Center.The study findings are published in JAMA
The Veterans Affairs Keratinocyte Carcinoma Chemoprevention
was conducted between 2009 and 2013,
where 932 veterans who had at least two prior basal cell carcinomas (BCCs) or
SCCs were selected. Each one was randomly assigned to either receive the 5-FU
cream or another cream but without the active ingredient.The veterans were
instructed to apply the cream twice a day on their face and ears for up to four
weeks. They were also given a 30 SPF sunscreen and skin cancer
The two groups were similar on
all accounts other than the cream that they received. Both groups were almost
exclusively white and male, with an average age of 71. Also, veterans typically
have spent a large amount of time in the sun during their years of service and
had the same self-reported degree of prior sun exposure and sunburn.
‘While current prevention methods like sunscreens and oral medications for carcinomas cease to work when no longer in use, 5-FU appeared to provide prolonged protection even after discontinuation.’
The veterans were asked to visit their centers twice a year
for two years for a follow-up with a dermatologist.
At the end of the first year after treatment initiation, 20
of the 464 veterans who received the placebo cream had developed a squamous cell carcinoma
that required surgery. However,
in the group that received 5-FU only five of the 468 veterans developed the
cancer. The research team noticed a 75 percent risk reduction in the group that
Among veterans who had a previous history of basal cell carcinoma
(BCC) and received 5-FU, 11% risk
reduction was noticed after the first year. However, this was not statistically
significant. Overall, after four years of treatment initiation, 298 of all participants
developed at least one BCC, and 108 had developed at least one SCC.
"This suggests that using the 5-FU can reduce the
resources needed to treat these carcinomas," Weinstock said.
"The most remarkable thing about this study is that now
we have something to use that doesn't lose its effectiveness when you stop
using it," Weinstock said. "But this is the first study of its type.
I'm hopeful there will be other studies that show other sorts of regimens that
last longer and do a better job over time as science progresses. This is an
important first step."
Side effects of
the skin cream
The cream does have common side effects like causing
redness, itchy, sensitive and crusty skin, but these reduce once the
application of the cream stops. At the end of 6 months of the cream treatment,
21 percent of the 5-FU group rated the side effects as "severe," and
40 percent rated them as "moderate."
Weinstock and colleagues are planning further studies,
including one to determine the cost-effectiveness of 5-FU treatment.
- In clinical trial, cream reduces squamous cell carcinoma risk - (https://www.eurekalert.org/pub_releases/2018-01/bu-ict010318.php)