What is chemotherapy?

Chemotherapy uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cancer cells that grow quickly.

Some normal cells also grow quickly. Because of this, chemotherapy can also harm those cells. This can cause side effects.

How is chemotherapy given for nonmelanoma skin cancer?

Chemotherapy for nonmelanoma skin cancer is most often applied as a cream or ointment on the skin. This is called topical chemotherapy. Chemotherapy is only used this way when the cancers are just in the top layers of the skin. The medicine is applied several times a week for a few weeks. You will be taught how to do this and can do it at home.

Intravenous (IV) chemotherapy may be used for squamous cell cancer of the skin after it spreads beyond the skin to lymph nodes and other organs. It may be done as an outpatient visit to a hospital. This means you go home the same day. Or it may be at your doctor’s office or a chemotherapy clinic.

Oral medicine is available in advanced cases of basal cell carcinoma. It can be taken at home like other oral medicines.

What types of medicines are used to treat nonmelanoma skin cancer?

The most common medicines used for topical chemo are:

• 5-fluorouracil (5-FU)

• Imiquimod. This stimulates the immune system to treat basal cell cancer.

The most common medicines used for IV chemo are:

• Cisplatin

• 5-fluorouracil (5-FU)

• Doxorubicin

• Capecitabine

• Topotecan

• Etoposide

The most common medicine used for oral chemo is vismodegib.

What are common side effects of chemotherapy?

Because chemotherapy affects cells that divide quickly, it affects some kinds of normal cells as well as cancer cells.

Possible side effects for topical chemotherapy can include:

• Red, itchy, and painful skin where the cream or ointment is being used, which goes away after treatment

• Infection, which can be treated with topical antibiotic cream

• Increased sensitivity to sunlight, which lasts for a few weeks after treatment

If your skin becomes inflamed and painful during treatment, see your healthcare provider.

IV chemotherapy can affect cells in many parts of the body. The side effects depend on the medicines used, but some common side effects include:

• Nausea or vomiting

• Loss of appetite

• Mouth sores

• Diarrhea

• Hair loss

• Feeling weak or tired

• Infections from low white blood cell counts

• Easy bruising or bleeding from low blood platelet counts

Possible side effects of the oral medicine for basal cell carcinoma include:

• Muscle spasms

• Hair loss

• Changes in taste

• Fatigue

• Nausea

• Vomiting

• Diarrhea

• Loss of appetite

• Constipation

• Joint aches

Working with your healthcare provider

It's important to know which medicines you're taking. Write your medicines down, and ask your healthcare team how they work and what side effects they might have.

Talk with your healthcare providers about what signs to look for and when to call them. For example, chemotherapy can make you more likely to get infections.  Make sure you know what number to call with questions. Is there a different number for evenings and weekends?

 It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.