Center For Radiation Oncology
Patients often have many choices for treatment of skin cancers. Countless small skin cancers are frozen, burned, shaved, excised, and treated every year by primary care doctors and dermatologists. Sometimes, skin cancers become larger, or involve the face or parts of the body where simple treatments may be inappropriate. For many decades, superficial radiation therapy has been favored for these types of skin cancers, for several reasons: control rates with modern radiation therapy are similar to what is achievable with aggressive surgery (i.e. Mohs surgery), organ function is usually not affected (for example, an eyelid skin cancer can be treated without removal of the eyelid), and most patients heal without scarring. Due to the excellent cosmetic results radiotherapy offers, many patients prefer radiation therapy over disfiguring surgery for treatment of skin cancers on the face. This is a personal decision, and your FROG doctor will discuss your options with you.
When a suspicious spot or lump is found, your physician will remove the growth and have it examined under a microscope. Should it prove to be cancer, there are many ways to treat the lesion. Procedures include surgery by excision, cryosurgery (freezing), electrodessication, laser surgery, and radiation therapy. Priorities in treatment decisions include the ability to cure the cancer, functional result after treatment, cosmetic result, cost (to the patient, both in dollars and time), and availability of physicians and equipment to treat skin cancers.
“Radiation therapy uses high energy rays to kill cancer cells, thereby destroying the cancer. Radiation is very effective in treating basal cell and squamous cell cancers, which are the most common skin cancers.”
Radiation may offer an advantage over surgery with respect to cosmesis and function for small lesions of the lip, eyelid, ear, or nose, as well as cancer over the shins in patients with poor circulation. In addition, radiation may be indicated for larger lesions that are fixed to bone or cartilage, cancers with rapid growth, recurrent cancers, or an incompletely excised (positive margins) cancer after surgery. Finally, radiation is often the only option in patients who are medically unable to have their skin cancer surgically excised, such as those who have multiple medical problems, are on blood thinners, or have cancer of the legs, especially in diabetics.
External Beam Radiation
“How much radiation and how many radiation treatments are given to a skin cancer depends on the type of radiation equipment used, the type and size of the cancer, and how deeply it has penetrated under the skin. Often, electron or low-energy photon beam radiation is used to treat skin cancers, as it is available in most radiation therapy facilities. Between fifteen and thirty treatments, given five days per week for between three and six weeks, are generally needed. While this form of treatment is effective, it is also very time consuming and commonly causes the nearby normal skin to burn and peel.
HDR and Leipzig Applicators at the Center For Radiation Oncology
A new alternative to external beam radiation is high-dose radiation (HDR), which is a tiny pellet of radioactive Iridium-192 (called a “seed,” because it is the size and shape of a flower seed) that is placed directly on top of the cancer. The Iridium seed is welded onto a cable, which retracts into a lead container (called a “pig” Ė no joke) when not being used. This method causes much less damage to the normal cells that are next to the cancer than external beam radiation.
There are different sizes of applicators to match the size of the skin cancer. The Leipzig applicator looks like a candlesnuffer: the “handle” connects to a hollow plastic tube (where the Iridium seed comes through). The “cap” (where the seed stops) touches the skin and “flattens” the radiation to deliver the appropriate dose to the cancer. The treatment does not cause any pain or sickness. Because the radiation is placed directly on the cancer, this form of treatment can deliver more radiation to the cancer cells in a shorter time than can external beam therapy. The higher radiation dose means that fewer treatments are required. Most commonly, a complete course of high dose radiation is completed in just six treatments lasting a few minutes each, given three days per week in two weeks. Leipzig applicator treatment is available at the Center For Radiation Oncology. In addition to fewer trips to the center,the Leipzig applicator gives a better radiation dose throughout the cancer and gives less radiation to healthy cells.”
“Overall, the treatment is much more convenient for our patients than electron beam radiation with the same excellent cosmetic result. “We are pleased to offer this option at the Center For Radiation Oncology.”
“While skin cancers are treatable, prevention is the best medicine. Remember the slogan for skin safety: Slap on a hat, Slip on a shirt, and Slop on the SPF 15.”
Center For Radiation Oncology is affiliated with Brandon Regional Hospital, South Bay Hospital, Florida Hospital Zephyrhills, Pasco Regional Medical Center, Memorial Hospital, South Florida Baptist Hospital, Town & Country Hospital, and Tampa General Hospital.
Doctors are available to speak to groups and organizations on a wide variety of cancer-related topics. They have developed workshops on prostate, breast, gynecological, lung, and skin cancers. To schedule a speaking engagement, please call (813) 662-6024, ext. 1.
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