Radiation options for localized skin cancer
Radiation is an excellent curative treatment option for many types of early stage non-melanoma skin cancers including basal cell carcinoma and squamous cell carcinoma. Treatment with radiation can be delivered in multiple ways depending on the size and location of the skin cancer. One method is known as high dose rate (HDR) brachytherapy. Alternatively, skin cancers that are larger or are located in areas where brachytherapy is not possible can be effectively treated with external electron beam radiation.
Brachytherapy for skin cancer
Brachytherapy uses advanced computer-based planning and treatment technology to deliver a high dose of radiation directly to the skin cancer while minimizing exposure of nearby healthy tissue. The planning process also ensures that the radiation dose is concentrated on the surface of the skin with excellent sparing of deep tissues or organs. This results in highly effective treatments with minimal long-term side effects such as skin scarring.
Choosing between brachytherapy and surgical excision
Both surgical excision and brachytherapy offer excellent rates of tumor control. However, in cosmetically sensitive areas such as the face, excision can sometimes result in disfiguring scars, or large defects that require reconstruction with skin grafts. Brachytherapy results in virtually no long-term scarring and is very well tolerated.
How is brachytherapy delivered?
Treatments are administered as an outpatient procedure with direct supervision by a specially trained radiation oncologist. A shielded applicator is positioned directly over the skin being treated. The applicator is then connected to a computer controlled robotic device that contains the radioactive source. The robotic device is programmed to position the radioactive source into the applicator to deliver a specific radiation dose precisely to the tumor. The entire process is monitored directly by your physician who is in constant communication with you through an intercom. The typical course of treatment is 7 sessions delivered approximately 2-3 times per week, but the total number of sessions may vary. Each treatment session is delivered over the course of a few minutes.
What side effects should I expect?
Overall, treatments are very well tolerated. During the weeks of treatment, you may experience limited skin redness, itching, or peeling. These changes occur gradually, are usually mild, and heal soon after treatment. Long term side effects are rare but include minor cosmetic issues such as a slight change in color of the treated skin, a possible minor scar at the tumor site, or hair loss at the treatment site.
External electron beam radiation
For skin cancers that are larger or located on areas of the body that cannot be treated with brachytherapy, external beam radiation using electron beams is an excellent treatment option. Electron beams are delivered through the same linear accelerators used to deliver conventional photon radiation, but have the unique property of depositing radiation dose near the surface of the skin without deep penetration into tissues or organs. This allows for treatments that are also very well tolerated, although the total treatment course may be slightly longer ranging from 3-4 weeks.