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Why I Say “No Thank You” to Efudex

I may be in the minority with my approach to skin cancer treatment, but I have my plastic surgeon to thank. He treated my skin cancer for over twenty years, up until his retirement. He was an excellent plastic surgeon who specialized in skin cancer treatment. While he encouraged me to regularly see a dermatologist (I was a bit lax in regular appointments in my early years of skin cancer, as I naively didn’t think it was a big deal after just one basal cell area), our care plan for me was that if I had any precancerous areas (typically called actinic keratosis or AK) spotted by the dermatologist, those would be treated by her, most likely by freezing the area. My plastic surgeon would remove any skin cancer areas I may have, either by excision or laser surgery. I had a few, but not many, precancerous areas that needed freezing over the years.

New dermatologist pushed Efudex

My plastic surgeon was not a fan of Efudex or other chemo creams that some doctors recommend, and upon doing my own research on the creams, I agreed with him. After my dermatologist moved out of state, I had a new-to-me dermatologist strongly recommend that I use Efudex to “get rid of what may be hiding under my skin”. She downplayed quite a bit what I could expect from using Efudex, saying that there may be a little discomfort but that it wasn’t too bad. She also failed to mention that some people are recommended to have repeated treatment, sometimes every year (or more often). That dermatologist told me that Efudex was great for treating any actinic keratosis areas people may have.

However, I learned in my research that at most, 10% of AK turn into cancer, which means that 90% or more do not. Some AKs will never develop into anything else, and some AKs go away without treatment.1 AKs do not turn into melanoma, and “the vast majority of actinic keratoses remain benign”, according to The Skin Cancer Foundation.1

Knowing the risk Efudex can have on pets

There’s no question that using Efudex can be hard on a person. I’ve read many stories, both in our community and online as well, about the nausea and light sensitivity that are also part of Efudex treatment, in addition to the pain and discomfort. I also discovered a warning about Efudex usage that isn’t widely publicized: Efudex can kill your pets. The Food and Drug Administration has warned pet owners that dogs, cats, and other animals may die if exposed to skin cancer creams that contain fluorouracil, commonly sold under the names of Carac, Efudex, and Fluoroplex.2 If you apply the cream with your hands and then touch your pet, or your pet licks an area where you have applied your cream, or your pet comes into contact with a cloth or applicator you used to apply the cream, or there is residue from the cream on your clothes, carpets, floors or furniture that your pet ingests, it could be fatal to your pet.2 Extreme caution should be used during Efudex treatment to keep it completely away from pets.

My decision to say “no thank you”

For me, using a chemo cream that will cause such discomfort and pain to treat something that may not even materialize, to take a month or more to heal from that after applying it for a month, and then to have to do it again in a year (or more often), isn’t something that I want to do, which is why I told that particular dermatologist “no thank you.”

I do realize that everyone is different, and skin cancer affects us differently. Your skin cancer is your cancer, and you have the right to have a say in your treatment options. If your doctor has recommended Efudex and it works well for you, that’s awesome. If you have tried it and found it doesn’t work well for you, or if you are hesitant about having that particular treatment, know that you have options. Research your options and find a doctor who will work with you in your care plan. This will go a long way in your battle with skin cancer.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.



  • jthorens
    2 weeks ago

    Have you used efudex to treat superficial basal cell carcinoma? If so, how many weeks of treatment did you do and was it successful?

  • Judy Cloud moderator author
    2 weeks ago

    Thanks for your question, @jthorens. Unfortunately I can’t answer it, as I haven’t/won’t use Efudex (I gave my reasons why in the article.). Perhaps some of our other community members can jump in to respond. Judy, Moderator

  • Bridget7050
    5 months ago

    I was supposed to have started efudex treatment last october for “questionable spots” & lots of ak’s, on my chest, back & hands, after having a small basal carcinoma removed from my back. (Lotttts of past sun exposure, fair/freckled complexion) Ive not found a time that seemed good to go through this treatment. The derms push using efudex..but ive done my own tca peels at home, for years, for cosmetic purposes, & seems to me that peels & efudex both accomplish the same thing, resurface the skin…is there something im not understanding about why efudex with WEEKS of suffering is the better choice over peels, with just DAYS of downtime rather than weeks?? Im so confused…

  • Judy Cloud moderator author
    5 months ago

    @bridget7050 I understand the confusion. This would be a great conversation to have with your doctor, about alternative treatment options and why your doctor keeps pushing Efudex. I’ve had several try to push it as well. Know that you are your own best advocate, and it’s okay to question why your doctor recommends something and it’s even okay to say no.
    Judy, Moderator

  • nanafights
    7 months ago

    I’ve had Efudex treatments twice and the pain was horrible. I posted both times in my personal blog with daily photos. I will not allow myself to go through that again. But with that said, I show those photos and my other treatments and surgery’s to help the person going through this fight. I can’t turn back the clock but I might save that one person.
    Thank you for sharing your story.
    Hope you will read my fight…

  • Judy Cloud moderator author
    5 months ago

    Hi, @nanafights! I am so sorry but somehow I missed your comment when it was posted. I’m so glad you’re sharing your story and helping to raise awareness!
    Judy, Moderator

  • Ronni Gordon moderator
    1 year ago

    A couple of people have said I’m too compliant. I usually do what they say. I drew the line at putting Efudex on my thighs and stomach and wrapping them in Saran wrap while I slept, however! I did try it one night and it was impossible to sleep. I have put a lot of Efudex on the rest of my body and like that it makes a lot of spots go away. It cleared up my hands really well. Since my dog doesn’t lick them, I’m all set. But good for you for thinking for yourself.

  • Nina M moderator
    1 year ago

    Thank you for sharing these thoughts, @ronnigordon! We’re so glad to have you as part of the team 🙂 – Nina, Team

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