Nonmelanoma skin cancer rates are soaring in people over the age of 65 due to lifelong, cumulative sun exposure. Mohs surgery is the gold standard for treatment of nonmelanoma skin cancers of the head and face, especially for high risk tumors. However, a 2019 study by a consensus of dermatologists published guidelines for the use of superficial radiation therapy for nonmelanoma skin cancers concluding that SRT is safe and effective for the treatment of basal and squamous cell carcinomas. The 5-year cure rate is 90.3%* is similar to cure rates for surgery.
What is superficial radiation therapy?
It is the use of external beam radiation to treat skin cancer and its symptoms. Targeted SRT penetrates only skin deep which helps to eliminate side effects. It works by damaging the ability of cancer cells to grow.
Treatment planning employs CT scans to create a customized treatment plan that conforms to the size, shape and location of the tumors. Treatments are broken into small, computer-controlled doses to provide effective treatment and lessen the risk of damage to healthy tissues.
Side effects include:
- damage to nearby healthy cells,
- redness, blistering, scabbing
- Skin infections
- Hair loss
- Damage to the salivary gland and teeth if the cancer is nearby
SRT is not recommended for use in young people because studies report that years after treatment new cancers can develop in previously treated areas. It is also not used to treat people with inherited conditions, lupus or scleroderma, or people at high risk for new cancers.
When is SRT used?
- SRT can provide a cure for small, early stage disease BCC and SCC located on the face, cheeks, forehead, chin, scalp, eyelids, ears, eyebrow, lip or nose when surgery would result in significant cosmetic damage. It is also beneficial to treat nonmelanoma skin cancers on the legs of older patients and those whose comorbidities prevent surgery.
- SRT is used to control cancer or relieve symptoms in patients who are poor candidates for surgery
- for patients who desire to avoid surgical scars
- to treat high risk SCCs after surgery to prevent recurrence
- to treat involved lymph nodes
- for pain relief where the cancer is incurable
Who is a good candidate?
Elderly patients with comorbidities that make it dangerous to have surgery, to treat unresectable large tumors or difficult to treat areas like lesions on the face, ears, eyes, brow and lip, and to destroy cancer cells in nearby lymph nodes or in tissue left after cancerous lymph nodes have been removed with surgery.
During your consultation with Dr. Sedrak, he will discuss your treatment options. All treatment decisions are based on your type of cancer, its location, your age and health.
Dr. Joseph Sadek is a board-certified and fellowship trained dermatologist and Mohs surgeon. He will provide you with information on your treatment options, based on your type of cancer, its extent and location, and your needs. The Texas Cancer Center has offices in Houston, Kingwood and Sugarland, Texas. When you need a good dermatologist, who provides state-of-the-art treatments and procedures in a compassionate and respectful setting, contact him.
Nestor MS, Berman B, Goldberg D, et al. Consensus Guidelines on the Use of Superficial Radiation Therapy for Treating Nonmelanoma Skin Cancers and Keloids. J Clin Aesthet Dermatol. 2019;12(2):12–18.
Garcovich S, Colloca G, Sollena P, et al. Skin Cancer Epidemics in the Elderly as An Emerging Issue in Geriatric Oncology. Aging Dis. 2017;8(5):643–661. Published 2017 Oct 1. doi:10.14336/AD.2017.0503