{"id":16092,"date":"2025-01-02T13:47:43","date_gmt":"2025-01-02T19:47:43","guid":{"rendered":"https:\/\/www.advdermatology.com\/?p=16092"},"modified":"2025-01-06T09:34:32","modified_gmt":"2025-01-06T15:34:32","slug":"superficial-radiation-treatment-the-drawbacks-are-still-the-same-as-they-were","status":"publish","type":"post","link":"https:\/\/www.advdermatology.com\/blog\/superficial-radiation-treatment-the-drawbacks-are-still-the-same-as-they-were\/","title":{"rendered":"Superficial Radiation Treatment: The Drawbacks Are Still The Same As They Were"},"content":{"rendered":"

\"\"<\/p>\n

Radiation treatment for skin cancer, including superficial radiation treatment (SRT), has been around for decades; however, recent advertising has brought this modality to the attention of some patients. Should I use it for my cancer? Dermatologists treat non-melanoma skin cancers \u2013 most commonly basal cell carcinomas and squamous cell carcinomas \u2013 in ways that are individualized to the patient and type of tumor. Not all skin cancers behave the same way, and each individual has different personal factors \u2013 state of health, age, lifestyle, etc. \u2013 to consider.<\/p>\n

Generally speaking, SRT could be used for low-risk skin cancers in patients who cannot tolerate other treatments due to poor health, age, or other factors. The treatment requires 15-20 visits to a physician’s office over the course of a couple of months, where a device is used to radiate the very top of the skin (hence the term, superficial). Unfortunately, in practice, it does not penetrate deep into the skin limiting its use for high-risk cancers, and does not have quality long-term data on how often these skin cancers return. The skin is not examined under a microscope, so there is no confirmation of cancer removal. Also, once the area is treated with radiation it damages not only the cancer cells but also the healthy skin around it. This has a few effects: In the short term it can cause irritation, blistering, peeling, and hair loss among other changes, and in the long term can lead to various types of scarring in the entire field treated. Also, if the cancer recurs or another develops in the area, radiation cannot be used a second time, and any procedure on the skin damaged from radiation can be more difficult. Image-guided SRT is also expensive. Given the many drawbacks, national cancer guidelines do not recommend SRT as a first or even second-line treatment option.<\/p>\n

There are various other treatment options available which are recommended as first-line by national medical societies. This ranges from Mohs surgery<\/a> to standard excisions to “scrape and burn” procedures (electrodessication and curettage), depending upon the cancer. The gold standard treatment for high-risk skin cancers is Mohs surgery. Named after Dr. Friedrich Mohs who developed the technique, skin cancer is removed with a very small amount of tissue around it, and it is examined under the microscope immediately to see if there is any skin cancer invading in one direction or the other. If so, that cancer is selectively removed. The skin is then carefully stitched together. Given that 100% of the skin is evaluated, the long-term cure rate is excellent \u2013 99%. This balance of high cure and tissue preservation makes it the most appropriate treatment for high-risk cancers and cosmetically sensitive areas.<\/p>\n

In low-risk skin cancers \u2013 for example, a superficial (surface type) basal cell carcinoma on the abdomen – there are a variety of alternatives. Often we consider excision, electrodessication, and curettage, or occasionally topical treatments or photodynamic therapy. These are all excellent low-cost alternatives that are appropriate in these settings. An excision, for example, is when the skin is cut out and stitched immediately. The skin is sent to the pathologist, but a slightly wider safety area of tissue can be removed to ensure a high cure rate. Again, this would be a first-line treatment for a low-risk skin cancer. A one day, cost-effective procedure with an excellent cure rate.<\/p>\n

At Advanced Dermatology, we’re always at the cutting edge of treatments, reviewing and re-reviewing our approach to individualizing patient care. For high-risk skin cancer, it’s clear that the gold standard of Mohs surgery remains just that. It gives peace of mind, knowing the cancer has been completely removed, and gives the best possible cosmetic and functional results. For low-risk cancers, there are a variety of options we consider. SRT at the time had many drawbacks, and while it may be used in low-risk cancers for those that cannot tolerate other treatments due to age or poor health, most often there is a superior therapy that will save patients time, is more cost-effective and doesn’t leave one wondering about recurrence or other complications.<\/p>\n","protected":false},"excerpt":{"rendered":"

Radiation treatment for skin cancer, including superficial radiation treatment (SRT), has been around for decades; however, recent advertising has brought this modality to the attention of some patients. Should I use it for my cancer? 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