V.A.-Brown study looks at cancer prevention

PROVIDENCE – A Brown University professor and dermatologist at the Providence Department of Veterans Affairs Medical Center has received a $10 million grant from the Veterans Affairs Cooperative Studies Program to see whether an easily available skin cream can prevent skin cancer.
Dr. Martin Weinstock, who teaches dermatology and community health at Brown’s Alpert Medical School, will conduct a four-year trial, focusing on basal-cell and squamous-cell carcinomas, which are usually not fatal but can be dangerous or disfiguring.
“It can destroy your eye, it can destroy your ear, it can destroy your nose,” Weinstock said in a news release. “It can grow into your skull, into your carotid artery. Once you have had one of these cancers, you’re at increased risk to have another, and the more times you have had it, the higher the risk of you developing even more.
The current standard of treatment for such cancers is to remove them surgically as they appear, but each one increases the risk of further cancers appearing. Weinstock will study the impact of applying 5-Fluourouracil cream to the face and ears of patients who’ve had at least two carcinomas in the last five years, aiming to reduce the incidence of cancers.
The cream is already used to treat actinic keratoses, rough pink spots of skin that may turn into skin cancer. A trial group of 1,000 patients will be recruited, drawn from 12 VA clinical centers around the United States, and monitored for two to four years.
Skin cancer accounts for more than half the cancer cases in the United States, Weinstock said: more than 1 million cases per year, including 100,000 annually in the VA.
In a news release, Weinstock said he doesn’t expect to completely eliminate the reoccurrence of skin cancers, but he could achieve “substantial reductions.” If treated for several weeks every few years, patients might reduce their cancer risk by more than 50 percent.
“A million cases a year, cut in half? That’s huge,” Weinstock said.
The study also will assess quality of life and cost of care. Weinstock said if it proves effective, this treatment will ultimately save money for the VA and for health systems nationwide.