SRT and Dementia
Skin cancer is the most common type of cancer, and approximately 1 in 5 Americans will be diagnosed with skin cancer by the time they turn 70 years old.1 Our lifetime accumulation of sun damage can be blamed for this increased risk, but that’s typically seen as a normal part of aging. We have to remember to take care of it as we age and stay on top of it.
What happens when someone starts to forget to take care of themself?
There are approximately 47.5 million people worldwide with dementia.2 Dementia can present in different ways, most commonly as Alzheimer’s disease. The severity of dementia can vary, but it can still impact a person’s health even at the mildest stages.
I often interact with patients who are experiencing dementia
In our dermatology office, we often encounter elderly patients with some level of dementia presenting with extremely large skin cancers. Dementia doesn’t necessarily mean the person has someone caring for them. They may have just forgotten to call for an appointment right when they first noticed it. Others may not recall how long the lesion has been there, and they thought it might heal on its own. This, unfortunately, allows for the skin cancers to go undetected for too long.
Extensive skin cancer surgery can be traumatic
Lesions that have had time to grow often require more extensive surgeries to remove them altogether. Large excisions mean more healing time and can come with more discomfort. Patients who cannot remember to care for large excisions can risk infections. In the later stages of dementia, it can be nearly impossible to keep someone from impulsively reacting to painful stimuli like needle sticks or sore excision sites. We have seen families and caregivers that did not opt for surgical removal of skin cancer because of how traumatic of an experience it had been previously.
SRT can be an alternative
Superficial radiation therapy (SRT) can be used in place of surgery for patients with dementia. With SRT, the patients have no post-operative care and, therefore, a lower risk for infection. The treatments are quick and administered by a radiation therapist trained in caring for patients of all kinds. SRT can be explained to the patient at each session, and weekly photos can show progress.
It might be a better fit or patients with dementia
Patients who may not know where they are or are non-verbal can do SRT (with scheduled transportation, of course). The treatments are very short, but the patient is also monitored during the duration. If they were to move, the therapy could be paused and resumed after repositioning the patient. There are no open wounds, and the risk of injuring the treatment site is much lower than with surgery.
We go through the process together
I have worked with SRT for four years. I have treated patients with dementia in many stages and conditions. I often find myself involved in the treatment process from reminding patients of scheduled appointments to explaining the entire treatment process at each visit. I usually do a dry-run of treatment before administering radiation treatment to someone with cognitive issues.
Restraining a patient is not part of the process
Never have I had to restrain a patient. I often find that if the patient places their hands over their chest and we lay the lead shield over the top, they are calm and able to remain still for the duration of the treatment. I commonly use supportive headrests and tape as a gentle reminder for patients to not drift from their position during treatment.
SRT might be what you're looking for!
In my experience, SRT has been a relief for families caring for a loved one with dementia. It is a painless procedure and extremely fast. There is a time commitment for the family to arrange for their loved one to come in for the series of treatments, but there is very little post-treatment care.
Have you or someone you know undergone treatment for skin cancer while experiencing dementia?
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