Does Fluorouracil Cream cure skin cancer

1. What fluorouracil cream is and what it’s approved to treat

Fluorouracil cream is a topical chemotherapy agent used primarily to treat actinic (solar) keratoses and, in specified situations, superficial basal cell carcinoma and squamous cell carcinoma in situ—conditions that sit at or near the skin surface and have been shown to respond to topical treatment ^{[1] [2] [6] [5]}.

2. How the medicine works on skin lesions

As an antimetabolite, 5‑FU interferes with DNA and RNA synthesis in rapidly dividing cells; applied to skin, it preferentially injures sun‑damaged and neoplastic epidermal cells, producing an inflammatory reaction, erosion and subsequent re‑epithelialization as abnormal cells are eliminated ^{[4] [3] [5]}.

3. Evidence that it “clears” lesions and reduces risk

Randomized trials and systematic reports show high clearance rates for actinic keratoses—multiple studies report 70–90% lesion clearance with topical courses—and field or full‑face applications of 5‑FU have been demonstrated to lower the short‑term risk of developing cutaneous squamous cell carcinomas in treated sites ^{[7] [8] [9] [5]}.

4. When topical 5‑FU can be considered curative and when it cannot

For small, superficial, well‑defined lesions such as superficial basal cell carcinoma or carcinoma in situ, topical 5‑FU can produce complete clinical and histologic clearance and is an accepted non‑surgical option in guideline and trial data, but for invasive, deeper, or higher‑risk tumors surgical excision, Mohs surgery, or other definitive therapies remain the standard because topical therapy cannot reliably treat deeper invasion ^{[6] [3] [4]}.

5. Limitations, monitoring and real‑world caveats

Efficacy depends on correct diagnosis, lesion depth and adherence to treatment; many sources stress dermatologic supervision because severe local reactions drive some patients to stop therapy and because cancers that look similar may actually require surgery—misuse or delayed biopsy can risk undertreatment ^{[10] [3] [5]}.

6. Safety, side effects and practical tradeoffs

Topical 5‑FU commonly causes pronounced local skin irritation—redness, swelling, erosion and pain—which is a sign of activity but can lead to infection or discontinuation; systemic absorption is usually negligible with localized use but total‑body or extensive application carries higher risks and requires careful monitoring ^{[11] [12] [13]}.

7. Clinical context, guidelines and alternative viewpoints

Clinical guidance positions 5‑FU as a valuable option for field cancerization and superficial disease and as an alternative when surgery is impractical or cosmetically undesirable; proponents highlight non‑invasiveness and chemopreventive benefit, while skeptics and surgical advocates point to higher cure certainty and staging information obtained by excision—this tension reflects differing priorities between conservative, field‑directed dermatologic care and definitive surgical oncology ^{[3] [4] [5]}.

8. Bottom line: does fluorouracil cream “cure” skin cancer?

Yes — but only in specific circumstances: topical fluorouracil can eradicate and be essentially curative for superficial, in‑situ or surface non‑melanoma skin cancers and for widespread actinic damage when used correctly under clinical supervision; it is not a universal cure for all skin cancers, particularly invasive or deeper tumors that require excision or other definitive therapies, and accurate diagnosis plus follow‑up are essential to ensure durable cure ^{[6] [2] [4]}.