Radiation Therapy an Effective Treatment for Skin Cancer
Skin cancer is the most common cancer in the United States. Skin cancers are more common in fair-skinned individuals with a history of long-term sun exposure.
Melanoma is the most dangerous type of skin cancer, but melanoma is rare compared to the highly curable types of non-melanoma skin cancers, which include basal cell carcinoma and squamous cell carcinoma. Each year in this country over one million people are diagnosed with skin cancer.
Skin cancer can be prevented by shielding the skin from the sun with clothing or sunscreen. Sunscreen should be rated at SPF (sun protection factor) 15 or higher. Children in particular should follow sun-safe practices, as skin cancers are caused by accumulated sun exposure over a person’s lifetime.
Most skin cancers are easily cured. Surgery is the principle treatment. A surgical technique practiced by specialist dermatologists called Moh’s micrographic surgery is particularly useful in removing skin cancers, while preserving the patient’s normal anatomy and appearance. Most cancers on the face are removed with the Moh’s technique.
While surgery is the most important treatment for skin cancer, it is not the only effective treatment. Radiation therapy is also highly effective against skin cancer. Consisting of focused energy created by special machines, radiation therapy is used every day to successfully treat prostate cancer, breast cancer, and dozens of other cancers.
Radiation therapy may offer an advantage over surgery for some skin cancers. While surgery for skin cancer is highly effective, there are some disadvantages. Some skin cancers are located in cosmetically delicate areas such as the tip of the nose, or the lip, or on other areas of the face. For these cancers, surgery many result in undesirable cosmetic effects. Radiation therapy has value in such cases: radiation therapy can eradicate the cancer while leaving the normal tissue (skin, muscle, etc.) relatively unaffected. Many patients with basal cell or squamous cell cancers of the nose undergo radiation therapy as an alternative to surgical removal of portions of the nose. Cure rates are exceptionally high when the treatment is delivered by radiation oncologists with proper skill and experience in skin cancer treatment.
Some skin cancers are too large or extensive to be removed by surgery. In such cases, radiation therapy can be used after surgery (or instead of surgery) to improve the chances for cure. Surgery is not always well tolerated by the infirm elderly, or by patients with advanced dementia or certain medical illnesses. For such patients and their families, the prospect of surgery and the subsequent wound care may be daunting. Radiation therapy may be an effective alternative for these patients.
A newer radiation therapy technique may allow faster and more convenient treatment for skin cancers. This technique, called high dose rate (HDR) brachytherapy, employs a tiny radiation source that is robotically positioned very close to the skin cancer for short periods of time. Special computers are used to design and deliver these treatments. In some cases, HDR brachytherapy treatment for skin cancer can be completed in as few as five outpatient visits. These treatments may be tolerable for nursing home patients debilitated by dementia (Alzheimer’s disease) who are challenged to follow instructions or to remain still for even short periods of time.
In summary, skin cancer is the most common cancer in the United States and a particular concern to fair-skinned residents living in the sunny Southwest. The best treatment is prevention: wear your sunscreen, hat and long-sleeved shirt! Skin cancers are highly curable and rarely life-threatening. Surgery is safe and effective. Radiation therapy may have value for some patients. Patients seeking consultation and treatment for skin cancer should demand the best technology, but the skill and experience of the treating physician is the most important factor to consider when selecting a dermatologist or radiation oncologist for the management of skin cancer.