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Verruca treatment for cancer patient?

Discussion in 'General Issues and Discussion Forum' started by Julz, Dec 31, 2007.

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  1. Julz

    Julz Member


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    hi was wondering if anyone can help me out...... i've been treating a lady with brain cancer (just routine nails) and she has developed some plantar warts on her heel which she says are very painful. i was wondering what wart treatments are ok for a cancer patient?? i'm sure some aren't allowed because of the chemicals (like how you cant die your hair when you've got cancer because of the chemicals). Does anyone have any advice or suggestions thanks :confused:
     
  2. RussAgg

    RussAgg Active Member

    Hi Julz
    It could be difficult if the patient is on chemotherapy and therefore immuno-compromised.
    Initially I would try debridement and occlusive therapy with duct tape or zinc oxide strapping.
    Give it at least 3 months and if no luck then try 50% sal. acid (with care!).
    Good luck. Russ.
     
  3. W J Liggins

    W J Liggins Well-Known Member

    I agree.

    Any treatment on an immuno-compromised patient is not going to be rewarding. I would advise limiting your treatment to conservative only to offer pain relief. Apeture padding will be useful.

    Bill Liggins
     
  4. twirly

    twirly Well-Known Member

    Hi Julz,

    I'm with Bill & Russ ie proceed with caution. I too would avoid aggressive treatment if the patient is immuno compromised.

    Bit Blue Peter ish (English kids programme for non-UK readers on the forum) but when I was at college a patient undergoing cancer therapy for leukemia presented with a painful VP which the staff advised against caustics etc.

    They did however debride the lesion, rub a lipstick over the area, placed a simple insole in the PTs. shoe & had her place her foot into the shoe to generate a ''lippy'' mark in appropriate area of VP. They then drilled a small depression into the insole & tada lady was comfy. ;)

    I know it isn't rocket sciency like the wonderful threads of Craig et al but if comfort can be achieved then maybe worth a try.
     
  5. Dido

    Dido Active Member

    Hi Julz,
    I would agree with all the advice given, ie:- at this moment there should only be palliative treatment offered.
    When the patient goes into remission you may well find that the VP spontaneously disappears. If not, you can review the situation when the patient's immune system is not so compromised.
    regards
    Dido
     
  6. Julz

    Julz Member

    Thanks this has been very helpful. : )
     
  7. Blumofe

    Blumofe Welcome New Poster

    I'm confused...why has NO one considered using either Carac or Effudex Cream. They are INDICATED to Melanoma and are being used for VP tx. They are both 5-Fluorouracil Cream and you apply them QD to the Verrucae with Occlusion. It should improve within 8-12 weeks, with serial debridements. Everyone sounded like just palliate and give up on this pt...
     
  8. admin

    admin Administrator Staff Member

    Blumofe :welcome: :good: - unfortunalty it may be the availability to podiatrists of 5-Fluorouracil Cream in the UK, that could be an issue. But, you right its a good option.
     
  9. W J Liggins

    W J Liggins Well-Known Member

    Hello Blumofe

    I will be grateful if you will post the links to any RCTs involving the use of 5-Fluoroucil cream in the treatment of VPs. This may well help in accessing the drug on this side of the pond.

    I don't think that any poster suggested 'giving up' on this patient; just offering palliative treatment until remission occurred and the patient was no longer immuno-compromised when more agressive treatment was likely to be effective.

    No-one has ever died from a VP; however, we are all aware of infections following agressive treatment. If such a patient is immuno-compromised then a potentially devastating outcome could occur; hence the advice, given in good faith.

    All the best

    Bill
     
  10. twirly

    twirly Well-Known Member

    Hello Bill,

    I 'googled'' it & results aplenty. Unsure how to paste results here though but worth a look. I googled flouroucil & verruca therapy.

    Regards, :drinks
     
  11. drsarbes

    drsarbes Well-Known Member

    You never said whether the patient was undergoing treatment for her CA.
    Has she had surgery? Chemo? Radiation?
    As you may know, some grade III brain tumors (i.e. astrocytomas) have a zero percent 5 year survival, so some opt out of treatment depending on symptoms.

    Warts are most likely the least of her problems. Make her comfortable.

    Steve
     
  12. Julz

    Julz Member

    Hi Steve,
    She has had surgery, radiotherapy, and has just finished her course of chemotherapy- she's getting the results of the treatment next week. I visited her this week debrided and used padding. i'm pretty sure she has terminal cancer as she's on my palliative list of clients however she is still doing quite well- dancing etc. i'll c how the padding goes and now that she's finished her chemo if they resolve. Thanks : )
     
  13. drsarbes

    drsarbes Well-Known Member

    Hi Julz:
    It sounds as though you are giving her comfort which is most likely all she wants and needs at this point.
    I have had some experience with this, it is really amazing how strong and upbeat these patients can be given their situation. Anything you can do to support this attitude is a plus.
    Good job.
    Steve
     
  14. twirly

    twirly Well-Known Member

    hello Steve & Julz,

    I agree, the pt. in question has rather more on her mind than an irritating V/P.

    I would aim for palliation as opposed to resolution & hope to achieve comfort.

    If this lady is 'dancing' keep comfort in mind.

    May she dance comfortably for a good while to come.

    My very best regards,
     
  15. pd6crai

    pd6crai Active Member

    Hey Twirly,
    Personally I would just use the banana skins to help reduce the pain of the vps. If she immuno suppressed it is unlikely to resolve anyhow. Bana skins definitely take the pain out of the lesions.
     
  16. drsarbes

    drsarbes Well-Known Member

    OK pd......I've heared the Banana skin thing before, and always thought it was just another home remedy. Apparently there is an old study from the early 80's that commented on Banana Skin application for warts.

    Do you have any non anecdotal proof that this helps......... and why?

    Don't you slip a lot! ............. (that's a joke!)

    Thanks

    Steve
     
  17. pd6crai

    pd6crai Active Member

    I used banana skin personally and it helped reduce the hardness of the vp and also reduced the pain of it. My nephew and cousin both had numerous and thats what they used and yip theirs disappeared. Granted they were young (10) but it was a painfree way to treat them.

    People going through big treatments do not need the pain of using acid therapies on VPs. This is a nice way to reduce pain and if it disappears well thats even better.

    I generally cut the banana skin to the size of vo, and stick it on with fixomull or mepore. And change it daily. It has worked, could have been a coincidence, but hey who cares, I think it works!!
     
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