When to Consider Radiation Therapy for Skin Cancer

Posted on September 21, 2015 in Skin Cancer

Written by Dr. Doline

Learn more about the author

Radiation therapy provides a safe, effective treatment for basal and squamous cell carcinoma in many cases.

Radiation therapy may be the best option for:

  • Patients with skin cancer in delicate sites on the face, such as those around the nose, eyes, ears, or lips, where surgical defects may harm the area or cause undesirable cosmetic damage.
  • Patients who have skin cancer that has been treated but has come back in the same location.
  • Patients with high risk squamous cell and basal cell lesions that have close positive margins, nerve invasion, high growth rate, or the possibility of nodal involvement.
  • Patients who have large skin cancer tumors that cover a large area.
  • Older adults (over the age of 60).
  • Patients who have poor overall health or underlying medical conditions that could lead to complication from surgery.
  • Patients on blood thinners or other medications that interfere with surgery.

Radiation therapy may also be used in conjunction with surgery in many cases to optimize effectiveness of treatment. Radiation may allow the surgeon to forego extensive surgical grafts, flaps or reconstruction if the combined modality approach is known ahead of time.

Surgery versus radiation therapy for skin cancer

Historically, surgery has been the most common way to treat non-melanoma skin cancer. Both squamous and basal cell carcinoma are slow-growing diseases that rarely spread beyond the original location of the cancer. Carcinomas often start out as abnormal moles or small patches on the skin that are unusual in color and texture, and frequently do not cover large areas of the body.

For these reasons, surgery is often an excellent option. Through various surgical procedures, including Mohs surgery, cryosurgery, and curettage with electrosurgery, a physician can quickly remove the cancer before it grows, spreads, or causes additional damage. The effectiveness of each surgical approach is different, but all have very high curative rates.

“At the same time, radiation therapy provides an excellent option for skin cancer, either as an alternative to surgery or an adjunctive treatment in combination with surgery. While surgery alone is often the right choice, especially in very young patients, for non-melanoma skin cancer, radiation therapy may be the best option in many cases.”
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