Poor candidates for surgery, elderly patients may consider SRT for skin cancer
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Key takeaways:
- Superficial radiation therapy is an external radiotherapy for skin cancer close to the surface.
- Patients with an aversion to surgery, desire good cosmetic outcomes or are elderly are good candidates.
MIAMI BEACH, Fla. — Patients who are elderly or are poor candidates for surgery with nonmelanoma skin cancer would benefit from superficial radiation therapy, according to a speaker at South Beach Symposium.
Superficial radiation therapy (SRT) is a type of external radiotherapy that treats nonmelanoma skin cancer that is close to the surface, with the majority of cases being basal cell and squamous cell carcinoma.
According to a presentation from David J. Goldberg, MD, JD, of Skin Laser and Surgery Specialists, Schweiger Dermatology Group and Icahn School of Medicine at Mt. Sinai, SRT is an ideal treatment for elderly patients and those who are poor candidates for surgery.
“These are the people I treat a lot,” Goldberg said, “because there is no pain, no bleeding and no surgery.”
According to Goldberg, some of the benefits of SRT that make it a great option to treat skin cancer in these populations is that it can be safely used in patients who are taking anticoagulants, have poor circulation or cannot do wound care.
Additionally, SRT is best for people with a significant fear of surgery and scarring.
“The cosmetic results are great,” Goldberg said. “Sometimes I feel like the scar you get following SRT is more from the biopsy being done, but it’s certainly not from the surgery.”
While SRT has very few contraindications, patients who have a pacemaker or defibrillator in the treatment area or have received previous radiation to the area of concern are not proper candidates for this treatment.
A complication to be aware of is temporary erythema, which occurs in almost all patients for 7 to 10 days. The severity of the erythema is usually related to the dose of radiation.
According to Goldberg, patients with Fitzpatrick skin types V to VI will “definitely” get some sort of hyperpigmentation.
“This is not so common in the skin cancer population,” Goldberg explained concerning hyperpigmentation. “But it is more common in the keloid population.”
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Goldberg DJ. Superficial radiation therapy (SRT) for NMSK. Presented at: South Beach Symposium; Feb. 8-11, 2024; Miami Beach, Florida.
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