Skin cancer is the most common type of cancer in the United States. For most people, surgery is the recommended choice for treatment. But there is another option that doesn’t involve surgery. It’s called brachytherapy.
Dr. Maikel Botros is a radiation oncologist and the medical director of the Prisma Health Cancer Center–Maryville. He uses brachytherapy to treat certain types of skin cancer, such as basal cell and squamous cell cancers. Brachytherapy is a short outpatient procedure with very few side effects that can be used instead of a surgical option. “Some patients develop cancers on areas of their face where surgical excision may result in a poor cosmetic outcome. Others may not be able to have surgery because of certain health factors, such as being on blood thinners that cannot be held for surgery or having conditions that may result in poor wound healing after surgery,” said Botros. “Patients often are amazed by how well they tolerate this treatment. Brachytherapy gives them a safe and effective option to treat their skin cancer. It’s quick, it’s simple, and the success rate is very high – greater than 90 percent.” This aligns with a study presented at the Radiological Society of America (RSNA) in 2019, citing results showed a cure rate between 96-98 percent, with excellent cosmetic outcomes in 90 percent of cases.
Brachytherapy uses a small radioactive seed to treat the cancer. It is placed very close to the skin cancer, often right on top of it. That way, the cancer gets a strong dose of radiation while the healthy skin around it stays safe. The treatment happens in a room with special equipment, including a robot. A small cone-shaped device, called an applicator, holds the radioactive seed in the right place. This device is designed to conform to the skin’s surface, treating only the most superficial part of the skin while ensuring precise delivery of the radiation. Botros is meticulous, checking and double-checking placement to ensure harm to surrounding tissue is minimized. “We are very careful with placement,” said Botros. “The treatment only takes about three minutes, and we can stop any time the patient needs to move or take a break.”
Most people come in for treatment two times a week for four weeks, for eight total sessions. The sessions are short and don’t cause any pain. After treatment, the skin may be a little red or itchy. Those symptoms usually go away within a few weeks of completing the course, and a cream can be prescribed, if needed, for the itchiness. There are no hospital stays, long recovery times or stiches to worry about. Patients can go home or back to work right after each visit and return to their normal routine. In a significant percentage of cases, the cosmetic results are excellent.
Brachytherapy is not the right choice for every type of skin cancer. That’s why it is important to talk to your dermatologist, who will determine if brachytherapy is an appropriate treatment based on your health issues, as well as the size, depth and location of your tumor. “When treating cancer, it’s always important to ensure you have a team of doctors who give input as to how to best treat your specific type of cancer. We strive to do this for every patient,” Botros explained.
To learn more about what the Prisma Health Cancer Center–Maryville offers, visit blountmemorial.org or call 865-977-5534.
