Pros and Cons of SRT

Every treatment has its own list of pros and cons. As the one providing the treatment, I may seem biased in favor of superficial radiation therapy as the best treatment. But I do see both sides, and I do understand that superficial radiation therapy is not the right treatment for everyone. Here is my completely non-biased, list of pros and cons for using superficial radiation therapy to treat non-melanoma skin cancers.

Cons of SRT

Superficial radiation therapy is not a "one and done" treatment. We cannot deliver the full dose of radiation needed to eliminate your skin cancer in just one session. We have to break up the dose into smaller amounts that don't hurt the healthy skin in the area. In our office, this typically means treatments 2-3 times per week for 5-7 weeks. The treatments need to be spaced out just right to allow for healing, but not too far that would allow the skin cancer to grow back. We do not want to have a gap in treatment that is more than seven days. This treatment comes with a bit of a time commitment.

Post-SRT skin side effects

The treated area will not have a surgical scar, but some patients have a change in the appearance of their skin after their treatment. In people with red undertones, they may find the treatment area is less red after the treatment. For those that tan easily, the treatment area may become more pigmented than the surrounding skin. These issues can be corrected with treatment, but it is considered a cosmetic side effect.

The site gets a sunburn-like reaction

Nothing extreme, but there is a red or pigmented circle in the area treated. It is easily covered or masked, but as someone who is contemplating SRT, you should know that a permanent pigmented spot may be a new part of your skin.

SRT is a specialty procedure

Superficial radiation therapy can get pricey without insurance. Insurances do pay for this treatment if it is part of your plan coverage. If not, you are probably looking at a bill of a few thousand dollars.

Pros of SRT

SRT is fast and pain-free

The initial biopsy is the only invasive part of this process. There is no feeling associated with the delivery of the radiation. The delivery of the radiation takes seconds and most patients say that it's the fastest doctor's appointment they have ever had! Throughout treatment, even when the site is red, patients say it doesn’t bother them.

You have no restrictions or limitations

You can do everything like you usually do; no stitches, no bandages, and no open wound. The treatment does not require anesthesia and you can expect to have no downtime after receiving treatment. You also are not radioactive, and completely safe to be around pregnant women and children.

The treatment course is typically done within a couple of months

It may seem like a long time, but when you think about the healing associated with surgery, possible tissue transfer, or post-operative reconstruction, you can end up with a longer timeline if you end up going under the knife.

We can radiate places that have already had surgery

If your first surgery didn’t remove it entirely, or if it’s a skin cancer that's really close to a previous excision, we can treat it without cutting back into old scars.

We can treat skin cancers almost anywhere

Skin cancers do not always form in the most considerate of places. Sometimes they form on parts of your skin that do not make for the easiest surgery. The nose, ears, inside the bowl of the ear, eyelids, fingers, scalp, and lips: we can, and we have, treat them all with superficial radiation therapy.

There is over a 99% cure rate with SRT

It is comparable to the cure rate of Mohs micrographic surgery. It also does not require a re-biopsy post-treatment to confirm the treatment's success.

What do you think? Do the pros of SRT outweigh the cons or is surgery your preferred treatment?