Skin Cancer Diagnosis - Do You Really Know "All" Your Treatment Options?

American Brachytherapy Society reinforces that those diagnosed with non-melanoma skin cancer can be treated with shorter, more targeted courses of radiation therapy using Skin HDR (High Dose Rate) Brachytherapy techniques.

RESTON, Va., June 13, 2019 /PRNewswire/ -- Skin cancer is the most common type of cancer, with an estimated 2-3 million people in the United States being diagnosed with non-melanoma skin cancer each year.1 The mortality rate is low, with about 2,000 people dying from non-melanoma, basal cell, and squamous cell skin cancer each year. However, incidences of diagnosis continue to rise, and skin cancer can significantly affect a person's quality of life if not properly treated.

(PRNewsfoto/American Brachytherapy Society)

Non-melanoma skin cancer is often curable when caught early and treated properly. Although there is no proven way to completely prevent non-melanoma skin cancer, you may be able to lower your risk. Consider these prevention techniques: 2

  • Know the signs and symptoms. The most common signs of skin cancer are changes to your skin's normal appearance, such as a change in an existing mole, a new growth, or a sore that doesn't heal.
  • Limit or avoid direct exposure to the sun between 10am and 4pm whenever possible.
  • While in the sun, always wear sun-protective clothing, including a hat that protects your face, neck, and ears.
  • Use a broad-spectrum sunscreen that protects against UVA and UVB rays and is SPF 30 or higher. Reapply sunscreen to sun exposed areas every 2 hours or immediately after sweating or being in the water.
  • Avoid sunbathing and do not use indoor sun lamps or tanning beds.
  • Examine your skin regularly, including yearly examinations by a health care professional and self-examinations in between visits with your healthcare provider.
  • Talk with your doctor about prevention and diagnosis if you have a higher risk for skin cancer due to things such as a personal or family history of diagnosis, a history of artificial tanning or prolonged sun exposure, or if you have fair skin.

A skin cancer diagnosis can be difficult and understanding the available treatment options can be overwhelming, and sometimes more confusing than the diagnosis itself. Lending to the confusion, there are many treatment options for skin cancer, some of which are more effective than others. Treatment options can include surgery, cryosurgery, electrocautery, external radiation, electronic brachytherapy, topical chemotherapy, immunotherapy, and photodynamic therapy.3 With so many options, many individuals will NOT be offered procedures with minimal side effects and high quality of life secondary to physicians offering procedures that they do themselves, rather than what may be most sensible for the patient's specific disease.

If you have been diagnosed with non-melanoma skin cancer the first thing you must do is, ask your physician about ALL your treatment options so that you can make an informed treatment decision.

Non-melanoma skin cancers most often occur on sun-exposed, and sensitive areas, such as the face, and surgery on these sites (nose, ears, eyelids, lips) may require multiple surgical attempts, re-excision or complex plastic reconstruction techniques under anesthesia to achieve positive outcomes and removal of disease.4 Additionally, while surgery has historically been the standard of care for the treatment of non-melanoma skin cancers in the United States, some patients may not be surgical candidates secondary to medical comorbidities, predicted functional outcome, or personal preference.

An alternative to surgery that patients should consider for treatment of their skin cancer is a highly conformal and effective form of radiation therapy with minimal side effects that is oftentimes not offered to patients by their diagnosing physician. Skin HDR Brachytherapy has been used to treat non-melanoma skin cancers for decades and is often the treatment of choice in cases of skin cancer which cannot be surgically removed without cosmetic deficits or for large lesions requiring extensive surgery and reconstruction. Despite this, it is not often offered to patients as a treatment option at the time of diagnosis. Several studies have reported excellent local control rates of greater than 90%, and favorable cosmetic outcomes with minimal long term side effects when HDR brachytherapy is utilized to treat non-melanoma skin cancer.5, 6, 7,8

Skin HDR Brachytherapy allows for customized radiation dose delivery to the patient's cancer while sparing adjacent, deeper, healthy tissue. The treatment is pain-free, noninvasive and does not require the utilization of needles, cutting or sutures. Skin HDR Brachytherapy has a distinct advantage for elderly patients, for patients with comorbidities where wound healing is of concern, and for patients who worry about cosmesis (preservation, restoration, or enhancement of physical appearance).

Unfortunately, many individuals diagnosed with skin cancer are never presented with Skin HDR Brachytherapy as a treatment option and/or, more regrettably, presented with misinformation.

Peter Orio, DO, President of the American Brachytherapy Society and Vice Chair of Network Operations, Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, commented: "Those who have recently been diagnosed with skin cancer must be informed of their treatment options and understand the benefits of brachytherapy as a component of their care. As physicians, we have an obligation to provide our patients both the knowledge and the power to make informed treatment decisions and patients must not be allowed to suffer the consequences of not understanding all their treatment options. Only a radiation oncologist who specializes in the delivery of brachytherapy should be the one to tell a patient whether they are a candidate for Skin HDR Brachytherapy, and patients must feel empowered to seek the opinion of an experienced brachytherapist when deciding on the care they want to receive. I truly believe that in medicine, knowledge is power."

Knowledge is Power. For more information regarding Skin HDR Brachytherapy, please visit https://www.americanbrachytherapy.org/skin-brachy/

About American Brachytherapy Society

Founded in 1978, the American Brachytherapy Society (ABS) is a nonprofit organization that seeks to provide insight and research into the use of brachytherapy in malignant and benign conditions. The organization consists of approximately 1,500 physicians, medical physicists, and other health care providers interested in brachytherapy.

The mission of the ABS is to benefit patients by providing information directly to the consumer, by promoting the highest possible standards of practice of brachytherapy, and to benefit health care professionals by encouraging improved and continuing education for radiation oncologists and other health care professionals involved in the treatment of cancer. Additionally, the ABS seeks to promote clinical and laboratory research into the frontiers of knowledge of the specialty and to study the socioeconomic aspects of the practice of brachytherapy.

Disclaimer: Not all patients are eligible for all treatments. Choosing a skin cancer treatment is a very personal decision and patients should be presented all the treatment options available to them based on their individual diagnosis and the data associated with any specific treatment.

Contact: Melissa Pomerene, mpomerene@virtualinc.com

1 https://www.cancer.net/cancer-types/skin-cancer-non-melanoma/statistics. Accessed, June 10, 2019.
2 https://www.cancer.net/cancer-types/skin-cancer-non-melanoma/risk-factors-and-prevention. Accessed, June 10, 2019.
3 Likhacheva at al. Skin surface brachytherapy: A survey of contemporary practice patterns. Brachytherapy. 2017; 16(1): 223–229.
4 Skowronek. Brachytherapy in the treatment of skin cancer: an overview. Postep Derm Alergol 2015; XXXII (5): 362–367
5Alam et al. The use of brachytherapy in the treatment of nonmelanoma skin cancer: a review. J Am Acad Dermatol. 2011 Aug; 65(2): 377-388.
6 Maronas et al. Treatment of facial cutaneous carcinoma with high-dose rate contact brachytherapy with customized molds. Brachytherapy. 2011 May-Jun;10(3): 221-227.
7 Sedda et al. Dermatological high-dose-rate brachytherapy for the treatment of basal and squamous cell carcinoma. Clin Exp Dermatol. 2008 Nov;33(6):745-749.
8 Guix et al. Treatment of skin carcinomas of the face by high dose rate brachytherapy and custom made surface molds. Int J Radiat Oncol Biol Phys. 2000, 47(1):95-102.

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SOURCE American Brachytherapy Society

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