Skin cancer is the most common cancer in the United States with almost Two million new cases diagnosed every year but Radiation Therapy (XRT) is a great option for treatment with results just as good surgery with better cosmetic results, and no need for anesthesia
FACTS ABOUT SKIN CANCER
Skin cancer is caused by exposure to ultraviolet rays (UV rays) mainly from the sun and from artificial sources such as in tanning beds. We see the most cases In Florida due the long strong sunlight hours and the older retired population. Heightened risk factors include: fair skin complexion, blond hair, blue eyes, work outdoors, chronic skin ulcers and immune depression such as in HIV infection or in patients with organ transplants on anti-rejection treatment.
TWO MAIN TYPES OF SKIN CANCER NON-MELANOMAS (SCNM)
Basal cell carcinoma (BCC): This is the most common form of skin cancer (80 %). These cancers begin in the outer layer of the skin (epidermis). Radiation therapy is very effective for curing basal cell cancers in more than 90 % of patients.
Squamous cell carcinoma (SCC): This is the second most common type of skin cancer (almost 20 %). These cancers also begin in the epidermis but are more aggressive than BCC. Radiation therapy can be used to treat SCC that start on the skin and may involve lymph nodes.
The third type is called Melanoma, and it is a more aggressive type of skin cancer and most deadly. However, it has an excellent prognosis when it detected early. Melanomas can occur anywhere on the skin, but is most often found on legs of women or backs of men, and typically occurs in moles. They generally have a black or brown lesion and the border, color and or surface is not uniform
Treatment Options Treating Skin Cancer
The treatment you receive depends on several factors, including the type of cancer, its location and extent, as well as your overall health, age and your personal choice. Treatments are often combined and can include the following:
Radiation therapy: The cancer cells are destroyed by radiation.
Surgery: The cancer cells are cut out and removed.
Moh’s surgery: A microscopic controlled surgery, allows surgeons to remove tiny layers of cancerous tissue while preserving healthy tissue.
Cryosurgery: The cancer is frozen.
Laser surgery: Cancer cells are destroyed by laser beams.
Electrodessication: The cancer is dried with an electric current and removed.
Radiation therapy approach
Radiation Therapy (XRT) is a commonly used modality for treatment of skin cancer with results comparable to surgery with excellent cosmesis but without need for anesthesia. XRT is the treatment of choice in certain areas where surgical resection has higher risks of creating cosmetic deformities. Also, it can be used when other treatment modalities have failed and the tumors recur.
There are many different XRT techniques available but the preferred ones today (both available at ICI) are:
EXTERNAL BEAM RADIATION THERAPY
External beam radiation therapy, (EBRT) which is highly effective, is given using a large machine called linear accelerator (LINAC) commonly delivering electrons. Usually the treatments are given in daily sessions, 5 days a week for 5 to 6 weeks. The patients can normally work while on treatment.
Brachytherapy (from Brachy: near, meaning short distance treatment) with High Dose Rate (HDR) is a very effective treatment option for skin cancer applied directly on the skin using custom made applicators for each individual patient. It is ideal for treating lesions in sensitive anatomic areas with irregular surface such as ears, nasolabial folds ,eyelids ,etc. High Dose Rate (HDR) Brachytherapy treatment is painless and the course is delivered in shorter time compared to EBRT. At ICI, treatments commonly last less than 5 weeks and are generally delivered in 2 or 3 days per week.
All treatments for skin cancer have minimal side effects. The side effects of treatment depend on the part of your skin treated, and the dose of radiation given and whether you also receive other treatments. Patients may experience redness like from sun exposure and sometimes moistness of the skin, pigmentation and/or discoloration. After treatment ends, the skin will form a protective scab and the new, healthy skin will develop underneath it. This healing may take some weeks and occasionally months.
However, with Radiation Treatments, patients can normally work or maintain their daily routines while on radiation treatment.