Can you use SRT on a...?
In the last few years, I have treated over 900 skin cancers. Just like each patient is different, so is each skin cancer site.
Where can we use superficial radiation therapy?
I am a radiation therapist, and I often get the question, "Can you radiate skin cancer if it is on (fill in location)?" and the answer is usually yes. I can treat skin cancers with superficial radiation in just about any location. We often use radiation to get skin cancers in tricky places.
Here are some of those tricky places:
Bowl of the ear
It may seem like an odd place to develop skin cancer. It is a location that is difficult to perform surgery on, especially with smaller ears. Instead of finessing a surgery, we can reach the bowl of the ear with superficial radiation. You may be thinking, "I don't want radiation near my ear; it will damage my hearing!" We have that covered, literally. We use lead shielding placed just inside the ear canal to protect it from any radiation exposure.
Helix of the ear
Another place on the ear, another equally excellent candidate for radiation. Instead of surgical removal, with a chance of causing disfigurement to the shape of the ear, we can treat with cancer on the helix of the ear with SRT. Just like the bowl of the ear, we use lead shielding in the ear canal to protect sensitive structures. We also use extra shielding behind the ear to protect the hairline from radiation. We can treat the skin cancer and preserve the natural shape of the ear.
A skin cancer diagnosis on the eyelid almost always comes as a shock to patients. There is even more shock when we recommend using radiation to treat it. If you thought you didn't want radiation near your ear, I know you are skeptical of radiation near your eye. Bear with me on this one. This is my most tedious treatment set-up, but it makes for a comfortable and happy patient. I start with numbing drops for the eye. As the numbing is kicking in, I prepare a lead contact lens. This lens will sit on the surface of the eyeball and not allow radiation to pass through. A lubricant is applied to the lens, and with a suction tool, I gently place the lens in the numb eye. Every patient has said, "Oh, that isn't bad at all." I then put a lead cut out over the site, exposing only the skin cancer. After a quick 30-second treatment, I am there to take out the lens and flush the eye with a saline solution. Easy peasy, I swear!
The fingers seem like an easy place to have skin cancer removed surgically. That is until you realize how mobile your fingers are and how often the bandaging gets wet and requires changing. Nobody voluntarily wants to not use one of their hands for two weeks. I had stitches in a finger for just a week (after slicing it open with a knife), and by day 3, I already wanted to take them out. SRT allows you to carry on your everyday day-to-day life without having to worry about bandages or stitches.
The scalp is one of the places that are less visible for most of us, making it harder to discover skin cancer until it is significantly larger. That leads to the next problem. The skin on the scalp is usually pretty tight and doesn't have a lot of extra slack for closing excisions. Radiation is excellent for skin cancers of considerable size on the tight areas of the scalp that does not have much hair growth. SRT can be used where hair does grow when needed, but it will cause the hair to fall out in only the treatment area. The treatment area is typically the size of the skin cancer with a small margin of tissue around the tumor on all sides, it would not affect the entire head of hair.
Surgeries on the lip are inconvenient while healing. They also make for a tricky surgery for maintaining the lip's natural appearance and function. Post-operative reconstruction procedures often follow surgical removals on the lip. When we use radiation, we don't compromise the lip. The treatment may cause chapped or a slight irritation, but those side effects subside after a few weeks.
I have yet to come across a non-melanoma skin cancer that I have not been able to treat.
Have you had radiation on a hard-to-treat spot? Tell us about it in the comments!
How well have your skin cancer diagnoses been explained to you?