Efudex: Is Bigger Really Better?

Topical chemotherapy is a difficult road with many hills and curves to navigate. It requires clear directions, a list of expectations, and some especially specific aftercare instructions. Notice, I said that it requires those things. That certainly does not mean this plan of treatment always comes with them. Unfortunately for many users, the prescription only comes with a quick note for where, how long, and how often to apply. I have learned over the years that this is certainly not sufficient, especially when it comes to the size of the area to be treated.

Learning the hard way

I want to be very frank with you. Efudex can be a beast. It does its job well for me, and I am always pleased with the results, but it is almost always a fight to the finish, especially when I treat a large area. I have learned to navigate this road, quite literally, by searching for skin cancer patients like myself online and reading about their experiences. From them and from some harrowing trial and error on my own, I have learned that size matters when it comes to application of this cream.

Treating my chest with Efudex

My first Efudex treatment was on my chest. I went with what my dermatologist recommended and applied from collarbone to cleavage in a large V-shape. As treatment progressed, I realized that this was considered a fairly large area.Side effects were also intense. The pain was, at times, almost unbearable. And the itching and burning was nonstop, 24-hours a day. I could not imagine applying to an area larger than this at once.

Treating large areas

Amazingly, I have seen other patients share that they are beginning treatment and have been told to apply to several large areas simultaneously. No… just no! While I am not a doctor and cannot give specific medical advice, I can share what I have learned from using Efudex myself many times. My advice on treating, say, chest and arms at the same time? Nope. Treating the face and chest together? Nuh uh. Both legs at the same time? Absolutely not.

Spot-treating usually goes more smoothly

There are not many Efudex users who don’t report frustrating and extremely uncomfortable side effects. In my experience, the larger the area, the more difficult the treatment. I cannot fathom trying to apply the cream for 3-4 weeks to both my chest and arms or both legs at once. Whew… I just can’t. My discomfort treating my chest was infinitely more challenging to navigate than the mild discomfort I had spot-treating my face. Spot-treating goes much more smoothly and with fewer and less intense reactions.

Scaling back

In all honesty, if I were told to treat two large areas at once, I would talk with my doctor and ask if spacing the treatments out would be acceptable. I have talked with fellow patients who have done just that. Perhaps treating one arm for a few weeks, allowing it to heal, and then beginning treatment on the other arm would be preferable, with the doctor’s blessing, of course. When it comes to battling the side effects and pain that can accompany topical chemotherapy, it is always worth double-checking with the prescribing physician and having a chat about scaling back. Your sanity is more than worth it.

Have you treated a large area or multiple areas at the same time? Would you do it again? Let us know in the comments.