Lymphedema and treating Actinic Keratosis (pre skin cancers)?

buttonsmachine

Does anyone have experience with treating actinic keratosis on their lymphedema side? AK's are usually treated by freezing with liquid nitrogen, or by using a topical chemotherapy cream. I have done both treatment methods in the past, but never to my lymphedema side.

According to my dermatologist, both methods cause inflammation and have the potential to aggravate lymphedema. The cream causes a lower spike in inflammation, but the inflammation will last for a longer period of time (roughly a couple weeks). Freezing will cause a higher spike in inflammation, but should last for a shorter amount of time (roughly a few days). I am basically hoping for the lesser of two evils here.

Does anyone else have experience with this? I'd be interested to hear what you did and how it went for you. Thanks!

SpecialK

buttons - I have prolific skin cancer - have had more than 40 basal cell lesions removed by a variety of methods over the last 25 years - and bi-lateral lymphedema. I have had biopsies, hard freezes, wide excisions, and MOHS surgery on my right shoulder and arm. Where is your AK lesion and where do you have swelling? I have not experienced any increase in lymphedema related complications with my skin cancer treatment, including an aggressive MOHS for an infiltrating basal lesion on my upper outer bicep area, which was actually a recurrence. I have used topical Aldara, but not on any LE locations, and have found that since they have removed the covering instruction the inflammatory response is not as bad. I think you might be OK with either approach, but I know that it is worrisome.

MinusTwo

I have mild breast & truncal LE. I don't allow any sticks or BP or IVs or blood draws on my arms. I am probably overly cautious - wearing a compression bra 24/7 and wearing sleeves & gauntlet when I fly. And I always have antibiotics w/me when I travel in case of cellulitis.

I DO allow freezing for AKs. In fact I routinely have 12-15 spots frozen when I have a full body exam every six months. Yup - I always lived in 'sunshine' states and spent a lot of time outside. I had SNB on both sides in 2011 & ALND on the right in 2013, but have continued with the derm doc freezing 25+ every year. Since I've already had 5 or 6 MOHS surgeries for basal cell cancer, I don't want to let the AKs grow. So I've 'been frozen' on at least 19 occasions since my BC diagnosis & initial surgery - with no less than 12 each time. So far - no problems.

Your information is really interesting. I never even thought to ask my dermatologist, although she does know I have LE. Wonder if it would help to ramp up the anti-inflammatory Vitamins C & A, D, E ??? a week before the derm appointments? I'll be asking my PCP and my dermatologist.

buttonsmachine

Thank you both for taking the time to answer. Your experiences give me hope that I can successfully treat the AK and not have a major impact of my arm LE. I wanted to ask here because sometimes doctors are dismissive of concerns around LE, but we as patients know how hard it can be.

The AK in question is on my finger just below the knuckle. My LE is relatively mild and diffuse throughout my arm, with the most problematic area being the upper back of my arm (where many of us ladies have that extra bit of fat). I am very diligent about wearing my compression and taking all the precautions I am supposed to, but I really don't want the LE to get worse than it is.

My dermatologist thinks my arm will probably be fine either way. But there's always that seed of doubt, and that fear of doing something to worsen the LE - at least that's how it is for me. I'm afraid of being the one person whose arm blows up from treating an AK that may never turn to cancer in my lifetime anyway. That being said, I'd hate to not treat it, and then have it turn into something that needs a bigger and more invasive surgery later on. Ugh.

Anyway, thanks again for the reassurance, it helps a lot. I'm just so exhausted with all the ongoing fallout from breast cancer treatment. It just never ends!

Spookiesmom

I have LE in both arms, and right hand. I’ve had numerous AKs frozen off, no problem. My dermatologist took a squamous cancer off my right knuckle early August. Said would take 2-3 months to heal. The biggest problem I had was it oozed lymph fluid for about a week. It’s gone now with no leaking or problems. You should be ok

buttonsmachine

Thanks Spookiesmom, I'm glad you didn't have any problems with it either!

My dermatologist said that for those of us with a compromised immune system (like me right now) freezing might be safer in terms of infection risk. When freezing, the wound is only open for a couple days before it scabs over and starts to heal, whereas the cream leaves you with an open and raw area for a couple weeks.

Anyway, I do feel that my dermatologist was thorough in explaining things to me. Hopefully I'll have no trouble with treating the AK.

ThreeTree

A little different angle here, but you might want to research/google frankincense oil and skin cancer and see if that might fit into your picture somewhere. I have had basal cells frozen off my nose several times, and I've had MOH's surgery on my nose also. Since then, I have been using frankincense oil on new emerging spots, while they are small, and it seems to do the trick. I put a few drops on the spot 2-3 times a day; I put it on "straight" and don't use a carrier oil as they say you should for some essential oils. I haven't had any problems with it. It can take weeks or even a couple of months to feel like the thing is completely gone, but it for me it seems to be a kinder gentler way to take care of these things. I came across the idea by accident while I was googling something else some years ago. I saw some subject line that said something about, "The truth about frankincense oil and skin cancer" and I dismissed it with a "yeah, right" sort of thought. I got more curious though, and started looking around more on the internet and there is actually some bona fide scientific research that shows frankincense oil to be an effective treatment for some skin cancer and other kinds of blemishes, so I would think actinic keratosis would fit in. Just another possiblility.

Best of luck to you with this!

buttonsmachine

ThreeTree, thanks for that info, I'll look into it! I have heard of people using apple cider vinegar for AKs, but never Frankincense oil. I have not tried any natural remedies for AKs so far - I generally go the "modern medicine" route, but I am also open minded to the possibility that natural remedies can work for some things.

MinusTwo

My problem is I live alone and can't reach most of the places on my back that the derm doc freezes. Even putting on lotion is a pain. Interesting info though.

ThreeTree

Buttonsmachine - I think modern medicine is a beautiful thing, but at the same time, I like to give some old fashioned home remedies a try first in many situations. While going through chemo, the oncologist kept pushing anti-acids, etc. on me and I told her I really didn't want to use them unless there was no alternative. I got through it all with ginger tea and eating large spoonsful of raw honey throughout the day. I am currently dealing with an ulcer and the doctors want me to take all the H2 blockers and PPI's, etc. I used to take care of stomach problems with raw sauerkraut and DGL just fine, but this time, things were worse, so now I am using the "hard core" stuff prescribed by the doctors, but also went out and got some sauerkraut and DGL. My hope is that the prescriptions will get it healed up enough that I can just take over again with the more natural remedies.

Minus Two - I know what you mean about those hard to reach places. I have the same problem. I also think I have a basal cell starting real close to one of my eyes and I have been reluctant to try and put frankincense oil on it, because I don't want the fumes to get in my eye. I still might give it a very careful try though, before going to a dermatologist.

buttonsmachine

ThreeTree, I can relate to much of what you are saying. It's true that sometimes we just need modern medicine, but if there is a less invasive, less disruptive option, I usually prefer to try that first.

As cancer patients we are in a tough spot, because while we definitely need our cancer treatments, I think we are also at risk of being over-treated just because we are always seeing doctors. The drugs that are supposed to help our side effects also have side effects, and then it just becomes a tangled mess. We definitely have to be our own advocates and know when it's "worth it" to follow doctor suggestions and when it's better to leave well enough alone.

ThreeTree

Buttonsmachine - Couldn't agree more!