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Radiation For Skin Cancer Gaining In Popularity

Skin cancer is extremely common, affecting more people than breast, colon and prostate cancers combined. The majority of skin cancers are easily treatable. Now, some dermatologists are using radiation instead of surgery to get rid of the threat.

Your skin is your biggest organ. Many times, it’s also the most abused organ.

  

"If you get two blistering sunburns or more during your childhood, that doubles your risk of getting skin cancer down the road," said 

Austin dermatologist Daniel Ladd, DO, who has changed his treatment of basal cell and squamous cell skin cancer over the last five years. Instead of treating most patients with tissue-conserving surgery to remove tumors, he’s now added a different option: superficial radiation.

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Superficial radiotherapy is a way to cure basal cell and squamous cell skin cancer lesions without surgery.

  

"All the patient hears is a beeping noise, kind of like when you get a chest x-ray," Ladd explained.

Unlike radiation for cancer deep inside the body, this topical radiation only penetrates a few millimeters into the skin, often as little as an eighth of an inch.

On average, 20 visits lasting only 15 to 30 minutes zap the cancer, leaving the healthy tissue intact.

Ladd says patients like the idea. "This new technology allows us to treat patients in our office with a non-invasive option for the very first time," he added.

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Ultrasound imaging shows physicians the depth and width of the skin cancer lesion, shown here as the black section between the white line and the green normal cells.

  

Bill Stewart of Cedar Creek is one of Ladd's patients. He laid down on a table while the doctor positioned the radiation device.

"No knives. No needles," Stewart emphasized, "which to me was a big deal. I get very nervous about any time I have to go under the knife."

Patients wear lead aprons and protective goggles. The instrument that delivers the therapy looks sort of like an x-ray machine at the dental office. Once it’s in position, a tech outside the room turns on the radiation. The patient is alone.

"It doesn’t feel like anything," Stewart described. "There’s no feeling. And afterwards, there’s no pain, no itching."

In order to target the therapy precisely and gauge its success, the superficial radiation system is guided by ultrasound, painless imagery that shows exactly how wide and how deep the skin cancer lesion is and if it has shrunk or disappeared.

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A technician who turns on the radiation for the patient sits at a console outside the treatment room.

  

Ladd said his practice used to rely on conventional surgery for skin cancer 90 percent of the time. Now, 70 percent of Ladd’s patients are opting for this less invasive technique.

"It’s not intended to replace surgery," Ladd cautioned. "Surgery is still a good option for many patients and always will be. This is just a nice alternative for patients who don’t want to get cut on."

The cure rate for radiation is comparable to surgery, about 95 percent. The therapy only works for non-melanoma skin cancer.

For diabetics at risk for infections or patients on blood thinners who don’t want to cut back on those medications for surgery, superficial radiation therapy is another option that’s gaining traction as an effective and safe alternative.

Ladd treats 10 to 20 patients a day this way. While multiple visits are more time-consuming than a single surgery, patients like Stewart say it’s worth it to them to avoid pain-numbing medications and potential scarring.

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Patients like Bill Stewart wear protective lead coverings and goggles during the brief therapy sessions.

  

"The procedure’s very fast," Stewart commented. "I’m in and out in just a few minutes. Just time enough to get the treatment and I’m out of here."

Most insurance companies, as well as Medicare, cover superficial radiotherapy for skin cancer.