There is a long history of self treatment of skin cancers with a variety of plant extracts including Aloe Vera ,Milk Thistle,Paw Paw and Euphorbia species.Laboratory studies at QIMR suggested that the sap from Euphorbia peplus had anti cancer properties with ingenol mebutate identified as the active compound.Clinical  studies have been carried out using the sap on  patients with non melanomatous skin cancer.Results of a pilot study using the sap of Euphorbia peplus will be presented.Studies using the purified compound PEP 005(Picato) are ongoing . FDA approval has been obtained for the use of PEP005 in the treatment of actinic keratoses and has commenced use in clinical practice in the USA.