Are you or a loved one concerned about a problematic skin condition or mole? Excessive or heightened exposure to the sun during the summer months can spur changes and even accelerate skin conditions. In this article, Radiation Oncologist Randal Hess, M.D., St. Anthony Cancer Care Center, shares the process for identifying and treating skin cancer and highlights radiation treatment as an extension and potential alternative option to surgery.
What is the first step to identify skin cancer?
Patients should pay attention to warning signs of skin cancer, which include any noticeable changes to the skin, increased skin irritability, itchiness, color changes or border irregularity on a mole. Seeking a clinical diagnosis is the first step in the right direction. Patients should set an appointment with their primary care provider, family physician or dermatologist, who can perform a biopsy to determine if the spot is cancerous.
If my biopsy results come back positive for cancer, what are my treatment options?
Depending on the type, stage, size, depth and location of the cancer, cryotherapy (freezing), surgery, radiation treatment or a combination of the treatments may all be options. All of these treatment options, with the exception of radiation, may be performed by a dermatologist or plastic surgeon. For small lesions, cryotherapy is a great option, but for larger areas, local excision or Mohs surgery may be required. Mohs surgery is a micrographic procedure that removes cancerous cells over the course of several hours. The provider works to clear all cancerous cells and ensures margins are clear. Radiation treatment may be used in conjunction with surgery, if the surgeon feels the patient is at high risk of reoccurrence, or it may be used alone.
What types of skin cancer can be treated with radiation?
Skin cancers that are not likely to spread – which include the two most common types of skin cancer, basal cell and squamous cell carcinoma – are more likely to be treatable with radiation. Due to the severity and risk associated with melanoma, patients with melanoma are not candidates for radiation therapy alone.
How is radiation treatment performed?
At St. Anthony, we utilize two types of radiation treatment to eliminate skin cancer. First, radiation treatment can be in the form of external beam therapy from a linear accelerator. This is the most common type of radiation therapy used for cancer treatment. It utilizes a machine to aim high-energy rays from outside the body into the tumor. A second option is brachytherapy, a process that utilizes a radioactive source and surface applicators to treat the skin. Both options are pain-free during treatment.
What are the benefits and draw backs of radiation treatment?
Using radiotherapy for early stage skin cancers has a significant cosmetic benefit and the equivalent curative power as surgery. With minimal scarring and less risk of changes in appearance, radiation treatment tends to be a more popular option for those with skin cancer conditions on their face or neck. While in the short-term patients may experience redness, tenderness, irritation, blisters and hyperpigmentation of the skin during the months following radiation treatments, the process is pain-free – and in a year’s time there is typically no visible sign of cancer or scar tissue on the skin.
In contrast, the process of going through radiation treatment is much more time intensive than compared to surgery. On average, most patients require 25 to 30 daily therapy sessions, lasting 20 minutes each (including wait time in office). Patients who opt for surgery can be in and out the same day, and fully recovered in four weeks. Therefore, surgery is commonly used for patients whose skin cancer may not be visible to others. What it really comes down to – is convenience or cosmetics more important in your particular case?
Which is a better option for treatment, surgery or radiation?
I am a firm believer in taking a multidisciplinary approach to medicine. Patients have a right to know they have multiple options when it comes to skin cancer treatment. It is our job as medical providers to inform our patients of the options so that individuals can make the most informed decision that is best for them. When I see patients with these types of skin cancer conditions, I also encourage them to meet with a dermatologist to learn about the options from each expert in their respective field.
What is the success rate of skin cancer treatment?
If detected early, cases of small skin cancer are curable with surgery or radiation treatment more than 90 percent of the time.
Do I need a referral for radiation treatment?
While you do not need a referral to set up an appointment at the St. Anthony Cancer Care Center, your insurance may require confirmation of cancer from your primary care provider, family physician, dermatologist or surgeon.
Does insurance cover radiation treatment?
Most insurances, including Medicare and Medicaid coverage, do cover radiation treatment after referral. Certain insurances may require preauthorization for treatment. Please be sure to contact your insurance provider prior to treatment, and the nursing staff at the St. Anthony Cancer Care Center will help you to complete any necessary phone calls and paperwork.
For additional information on radiation treatment, or to schedule an appointment with Dr. Hess, please contact the St. Anthony Cancer Care Center, Monday through Friday between 8:00 a.m. and 4:30 p.m., at (712) 794-5265.
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In this example of advanced skin cancer of the nose, the cancer would have required extensive surgery and a nasal prosthesis. Treated definitively with radiation therapy, Dr. Hess was able to remove the cancer and maintain the structural integrity of the nose.
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This is an example of early stage skin cancer in close proximity to the ear structure. This cancer may have required extensive surgery and loss of a third of the lower ear and ear lobe. With radiation treatment, Dr. Hess was able to eliminate the cancer with minimal scarring.
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