Cansema

By Dr Davin Lim

What is the science behind cansema or black salve treatment?

This treatment is termed escharotic in nature, meaning one big scab formation secondary to immense skin irritation & inflammation. Some skin cancers can be cured with immense collateral damage. 

📷 @Kingscliffhealth 

What is contained in prepacked Cansema?

The source of Cansema will vary, & hence the active ingredients. Some formulations include; zinc chloride, glycerin, botanicals & preservatives (kind or contradictory for natural remedies) .For more product information contact the company that sells Cansema.

What are other natural remedies for skin cancer?

There are many sensible alternatives to Cansema. The aim of any cancer treatment is to remove the cancer & follow up for recurrence. If you are keen on only ‘natural’ remedies, possibly seeing a skin cancer GP or dermatologist for at least a diagnosis would be great! They can guide you as to the type of skin cancer. From there you can do your own research on the aggression of the tumor you aim to treat & make an informed decision from there.

Nitrogen is natural. It is found in the atmosphere. Lowering the temperature will give liquid nitrogen. You have a freezer at home right? A skin cancer GP or dermatologist will have a freezer at work to keep this natural gas in its liquid state. Contemplate natural nitrogen gas as an alternative. 

Now, what is dermabrasion? This is a sander. You may find someone who still practices salt abrasion. This is painful, you can take some natural cannabis if this is legal in your state to help you get through this process. Someone can rub coarse salt to the cancer. Follow up with a biopsy. 

Fire is also natural, consider diathermy. This uses heat to destroy the cancer. A pre and post biopsy is ideal. In summary, there are many natural ways to help fight cancer, ideally a pre & post biopsy is best. Identifying the type of cancer prior to treatment with cansema will also give you time to sort out your will. For example treating aggressive melanoma or Merkel cell carcinoma with Cansema may give you 2-4 months before probable metastatic spread. Sorting your will early will improve your quality of life towards the later stages of terminal metastatic cancer. 

Disclaimer: I am not a screening dermatologist, but a procedural dermatologist. In the context of skin cancers, I only see DVA patients for management of complex tumors or significant solar damage. 

How would I know if Cansema has worked?

Your supervising naturopathic skin cancer expert can guide you. If you have any concerns, seek a second option from a skin cancer GP or your dermatologist. In some cases they may advise you on a biopsy. In other cases they may suggest a PET scan, Ultrasound or a CT scan to see how far the partially treated cancer has spread. 

What types of skin cancer can be treated with Cansema or Black Salve?

If you must, the ‘safest’ skin cancer to treat with Cansema is a superficial BCC, preferably located on the arm, or trunk. This has the least potential to spread, additionally the least potential to involve nerves (perineural invasion). 

Incompletely treated invasive cancers on the head & neck can invade nerves. The earliest signs of nerve invasion include tingling, paresthesia & ‘electric shocks.’ 

Once in the brain, you may experience some minor inconvenience in your life- examples include uncontrollable fitting, tremors, collapse, & memory loss. This should not be confused with the side effects of medicinal cannabis you may be taking for the terminal pain associated with the spread of the cancer you attempted to treat with Cansema. 

📷 Flickr/Eli Christman

How do you prepare Black Salve / Cansema?

Follow the instructions on the packaging. Most black salve products contain emulsifying agents, hence the need to mix or stir before application. Use a toothpick or the end of a cotton bud. Most formulations will turn from black to dark green after 30 seconds of mixing. Formulations differ, hence follow the instructions.

Disclaimer: My role is not to discredit nor advocate cansema use. For my balanced viewpoint, read the paragraph at the end of this page. 

How do you apply Cansema?

Black salve can be applied with a fingertip application, remember to wash your hands before & after application (make sure you don’t touch your genitals with cansema). Apply the product with a 5 to 7 mm clinical margin on the lesion in question. 

What to expect after the Cansema application?

Application of Cansema is followed by tingling of the treated area. This may last a few hours. Typically after 24 hours, Cansema is removed, then reapplied as above. 

How do you deal with any pain associated with a Cansema application?

The majority of patients will experience mild pain & stinging. A minority will experience pain. If you experience pain, panadol or Nurofen may be taken (sort of hypocritical to take these medications when you are contemplating a natural remedy). In this case, if you live in an area where medicinal cannabis is legal you may inhale some Mary Jane, inhale a reefer, smoke some blunt, buds, stinkweed, hay, pot, weed, grass, rope, gangster, boom, blunt, or good quality ganga. This will take away the pain associated with the Cansema application. This can also be used to alleviate the pain you may feel from secondary metastatic cancer if Cansema does not work & your SCC or melanoma spreads to your lungs & brain.

How do you treat multiple areas of skin cancer with Cansema?

A good way to manage skin cancer using creams of any sort, is to treat one lesion at a time. Good photographic documentation (with or without biopsies) are required. This way your naturopathic doctor can pick up early cancer recurrence before it spreads to your lymph nodes. 

If you experience pain, treating one lesion at a time can decrease discomfort. For very large skin cancers, your naturopath may ask you to apply Black Salve in sections. Be guided by their expertise in the management of skin cancers. 

How long should you continue Cansema for?

Cansema causes eschar or scab formation. Most naturopaths who advocate Black Salve advice treatment of 10-21 days. There is no scientific literature to prove or disclaim the duration of treatment. 

Can this treatment be repeated?

Some practicing Cansema users do not advise a second or third treatment as reapplication can result in more scarring (on top of the first application). With subsequent applications there will be more pigment loss & bigger holes. Other Cansema practitioners advocate a second or third course of Cansema to mop up any recurrence. 

If there is clinical evidence of recurrence, a sensible course of action would be to clear up your skin cancer (as this was the aim of initial treatment). It is important to rule out cancer spread. Simple biopsies can be done by a doctor. Clinical examinations include lymph node palpation. Amelanotic melanomas can look like benign Basal Cell Cancers or even IEC - Bowen’s (Google Image Search: Amelanotic Melanoma.) For these lesions, recurrence usually requires a PET Scan or imaging to exclude spread to other sites, including the liver, lung or brain. 

Disclaimer: I do not do routine skin checks, nor do I manage skin cancers. My work focuses on treatment of scarring from skin cancer surgery.

What happens if Cansema treatment is not successful?

It really depends on the age of the patient, the location & the aggression of the tumor. For example if it is a superficial BCC or IEC on the arm of someone in their 80s, chances are, the patient will outlive the tumor. 

On the contrary, if the tumor is say an amelanotic melanoma on someone in their 30s, chances are, metastatic spread will occur within 6-12 months if incompletely treated. If you have undergone treatment of your skin cancer with Cansema, see a skin cancer doctor or your dermatologist for follow up. 

Disclaimer: I do not do routine skin checks, nor do I make the call regarding cancer clearance. My job is to repair the scars caused by all forms of skin cancer therapy including surgical, curette, freezing, & chemical treatments such as Cansema.

Does Cansema application scar?

Cansema works by causing severe inflammation & necrosis, eating away at tissue (both tumor & normal skin). This treatment is classed as escharotic; which means it forms an eschar or big black scab devoid of any blood supply. Similar effects can be given with battery acid. The aim of black salve is to give a large & deep escar. This has the best chance of treating the skin cancer. 

Most cases of Cansema treatment will leave a scar (as this is the endpoint). The majority of scars are devoid of pigment, known as a depigmented or hypopigmented scar. In most cases the scars are atrophic (divots or holes), in some cases the scars are hypertrophic or raised. Occasionally they are keloid. 

How do I manage Cansema scarring?

If I suspect that there is recurrence of cancer, I will refer patients to my medical colleagues  for management. Simple biopsies or serial photographs can determine if the treatment is effective. Depending on the skin cancer treated, lymph node palpation is part of the clinical examination. 

If there is no evidence of cancer recurrence, procedures such as laser resurfacing can be conducted to reduce scars. If there are areas of atrophy, (holes or divots), several sessions of autologous fat grafting may be required in order to correct contours changes. Pigmentation changes such as hypopigmentation are harder to correct. The use of pigment cell transplantation such as Recell may be required. 

Davin’s Viewpoint on the use of Cansema

I am not against the use of natural ingredients to treat conditions like acne, pigmentation, wrinkles, photoaging & even warts. Dermatologists have learned and embraced many botanical ingredients including tea tree oil, licorice root extracts, bearberries, soy, flavonoids, green tea, & wildberries. We have learned from naturopathic medicine an immense amount of knowledge about using natural extracts to treat common skin condition. 

Treating cancer with natural remedies is probably not the most sensible thing to ‘try out’. Regardless, some people will try Cansema. My role is not to convince you that mainstream medicine is best for treating cancer, but to potentially revise the scars left from cancer treatment- this includes mainstream surgical cases as well as alternative medicine Cansema treatment. I don’t ask why, I just do. 

If you would like natural treatment for skin cancer, consider seeing someone who can take a biopsy of the cancer, at least this gives a prognosis. From there you can try natural solutions such as sandpaper or salt dermabrasion, especially for non-life threatening cancers like superficial basal cell carcinomas. Naturopathic treatments for melanomas & squamous cell cancers are not a good idea. 

Disclaimer: I do not perform skin checks, nor do I give advice on the use of any skin cancer treatment, either natural or mainstream medical. I class myself as an operator, namely to perform procedures designed to correct a condition. In the case of Cancema, my primary role is to improve the scarring from this treatment. If I suspect recurrence I will take steps to refer patients to medical professionals to make this call.