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Another option for skin cancer

Squamous cell and basal cell carcinomas are the two most common types of skin cancer. They impact 3 million Americans each year, a large percentage of them seniors. The most popular treatments for these cancers typically include surgical removal and external beam radiation therapy.

But for elderly patients who may not be good candidates for either of these treatments, a non-surgical alternative called high-dose-rate brachytherapy may offer excellent cure rates and cosmetic outcomes, according to new research on the procedure.

In high-dose-rate brachytherapy, a precise dose of radiation is delivered directly to the cancerous cells through catheters implanted into a custom-fitted applicator. A course of treatment includes six three-minute sessions over two weeks. By contrast, external beam radiation treatments can last up to six hours at a time, over a period of six weeks. 

“For elderly patients who don’t heal as well and may have additional medical problems, surgery may not be the best option,” said Ashwatha Narayana, M.D., chairman of the Department of Radiation Oncology at Northern Westchester Hospital in Mount Kisco, New York. “Treatment with external beam radiation therapy can [also] be too long and painful … It also exposes healthy tissue around the lesion to radiation, which can increase side effects.” 

Narayana said brachytherapy delivers a higher dose of radiation directly to the tumor while sparing healthy tissue nearby. Patients have minimal recovery time and typically experience little or none of the nausea, hair loss or diarrhea external radiation can cause. They can also return to normal activities after the procedure.

During the study, radiologists used high-dose-rate brachytherapy to treat 70 patients between the ages of 70 and 100 who had early stages of skin cancer. 

“We had a cure rate of 96% in patients with squamous cell carcinoma and 98% in patients with basal cell carcinoma, and cosmetic outlook was excellent in 90% of cases,” Narayana said. “This is a great treatment option compared to surgery…The results are impressive.”

He added that while brachytherapy has thus far failed to catch on as a treatment for non-melanoma skin cancers in the elderly, he hopes results of this study will help raise awareness of what he called a  “powerful” treatment alternative.

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