Dermatologists and Radiation Therapy

A dermatology office that is interested in owning and operating a superficial radiation therapy (SRT) machine must do more than just purchase the device. If your dermatologist offers SRT, they have done a lot to make this treatment accessible for their patients.

What is SRT?

Radiation for skin cancer is a superficial, or skin-deep dose of radiation that destroys the cells in non-melanoma skin cancer. Radiation can be a great alternative treatment choice for patients who are not surgical candidates. There is no anesthesia, no cutting, no stitches, no downtime, no scarring, and no need for post-treatment reconstruction.

What does it take to have SRT in your dermatologist’s office?

A permit is necessary for a practice that uses an SRT unit, and the permit is specifically called a "dermatology supervisor and operator permit." This permit is only accessible to a dermatologist that has successfully passed the state’s dermatology supervisor and operator permit examination. The examination requires the dermatologist to understand the following topics: radiation physics, electricity and electromagnetism, production and properties of X-rays, biological effects of ionizing radiation, radiation hygiene, the structures and functions of the skin, applications of X-rays in dermatology, and the state laws and regulations regarding radiation and dosages. This information is critical for prescribing radiation safely. This preparation allows your dermatologist to understand what this treatment will do to your body at a cellular level. It also prepares them for any challenges you may face while under treatment.

Is it safe to be in a dermatologist’s office that has radiation?

Yes, it is safe to be inside an office that offers radiation therapy. The SRT unit does not give off radioactivity unless it is actively treating a patient. When the unit is on and delivering radiation, the machine is in a space that allows for the protection of people outside the “treatment room.” Our treatment room was outfitted with lead shielding to confine the radiation to that room in our office. By law, the patient is the only person allowed in the treatment room while the radiation beam is on. Radiation detecting devices monitor any exposure outside of the treatment room.

Does your dermatologist administer your treatment?

No, your dermatologist will not be administering your treatment in most cases. Your dermatologist is responsible for supervising the operation of the radiation unit and ensuring that anyone applying radiation to another human meets the education requirements, training, and experience. A dermatologist will hire a therapeutic radiologic technologist, also known as a radiation therapist, to treat patients. A radiation therapist will also have specific training. The prerequisites for the job require a degree in radiation therapy technology, board certification by the American Registry of Radiologic Technology, and in some states, licensing by that state's department of public health radiologic technology division. The technologist will be trained in operating the machine effectively and safely.

Is this the same as radiation in a cancer center?

Cancer centers have a variety of large linear accelerators that treat using different energies and different types of radiation. These machines are powerful and can treat cancer within the body. A dermatology SRT unit does not have the same power. The SRT unit treats at lower energies only capable of treating the skin's surface layers. This low level allows the machine to be much smaller than a cancer center and easily installed into a dermatology office. These small units are perfect for their use on skin cancers.

Not every dermatology office has a radiation unit, but they may refer patients that are good candidates for the therapy to a colleague that offers SRT. Talk to your dermatologist to determine if SRT is the proper treatment for your skin cancer.

What questions do you have about superficial radiation therapy? Leave them in the comments!