How is extramammary Paget’s disease (EMPD) treated?

In most countries, surgery is the common treatment for extramammary Paget’s disease (EMPD). However, if surgery is not possible, or desired, some patients use other options including: topical treatments (such as Imiquimod, also known as Aldara), CO2 laser, photodynamic therapy, cavitational ultrasonic surgical aspiration or radiotherapy. 

Surgeries include both Mohs micrographic surgery (which may not be available in all countries) or wide local excision or a combination of both. Like all cancers, early detection is helpful in having a successful outcome. EMPD care can vary widely and as such consultation with several doctors, in a multidisciplinary team approach, has been useful for some EMPD patients.  

Mohs Surgery

Mohs surgery is a precise surgical process in which a dermatologic surgeon performs the surgery and then examines the margins of the removed tissue under a microscope to determine if any cancer remains. It works very well when small defined areas of extramammary Paget's disease (EMPD) are located. Read More →

wide local excision

A wide local excision (WLE) surgery is a procedure that removes diseased tissue, leaving a margin of normal tissue. WLE works well when a larger area of extramammary Paget's disease (EMPD) is located or in combination with Mohs surgery. Read More →

Imiquimod (Aldara)

Imiquimod is a topical cream that acts as an immune response modifier and is generally used to treat genital warts, basal cell carcinoma and actinic keratosis. The product was approved by the FDA in 1997 under the brand Aldara (produced by 3M) but later became available worldwide under other brands. Immune response modifiers attempt to activate the immune system to fight abnormal cell growth. Read More →

CO2 Laser

The carbon dioxide laser (CO2) was developed in the 1960’s and is still used in specialized medical applications today. The CO2 laser works especially well with skin deficiencies and has been used with extramammary Paget’s disease (EMPD) patients. Read More →

Photodynamic Therapy (PDT)

Photodynamic therapy (PDT) is a medical treatment that utilizes a photosensitizing molecule and a light source to activate an applied drug. PDT essentially has three steps. Read More →

Cavitational ultrasonic surgical aspiration (CUSA) 

A few EMPD patients also report successful Cavitational Ultrasonic Surgical Aspiration (CUSA) procedures when a small area of extramammary Paget’s disease (EMPD) needs to be removed. Read More →

Radiotherapy

Radiotherapy (also known as radiation therapy) may be beneficial to some that are medically unfit for surgery or when surgery is not considered due to the location their EMPD. Radiation works by disrupting the DNA inside the cells. Read More →

Summary

All of the varied treatments described here have varied levels of success as well as potential side-effects. Since extramammary Paget’s disease (EMPD) cases vary widely, it is important to work with your physician to determine the best treatment plan for your situation. This information is not intended as a substitute for professional medical care.