Radiation Therapy for Skin Cancer Produces Excellent Outcomes

Skin cancer is the most common type of cancer, with basal and squamous cell carcinomas accounting for the majority of cases. Individuals are typically referred to dermatologists for a biopsy and treatment, which may involve Mohs surgery or other surgical intervention.

Although these methods are highly effective, there is an equally effective alternative: radiation therapy.

Radiation oncologist Sean Quinlan-Davidson, MD, Lehigh Valley Topper Cancer Institute, says that radiation therapy can be a first-line treatment for most nonmelanoma skin cancers.

“Depending on the size of the lesion patients can require as little as one-and-a-half to four weeks of treatment, with daily or every other day sessions involving less than five minutes of radiation exposure,” he says.

Oncologic outcomes are similar to surgery, and cosmetic results can be superior. The treatment is noninvasive. Side effects may include temporary redness or scabbing, but people are usually able to continue their normal routines.

In December 2019, the American Society for Radiation Oncology published clinical guidelines for the use of radiation therapy for basal and squamous cell cancers in definitive and adjuvant settings. Similar guidelines also were developed by dermatologists.

Quinlan-Davidson says most of the skin cancer patients he treats require post-surgical adjuvant therapy.

“In many cases, these patients could have been treated with radiation alone,” he says.

A key benefit, he notes, is the shorter wait time for treatment. While people sometimes wait weeks for a dermatology or plastic surgery appointment, he can generally schedule individuals for their first radiation treatment within a week of their referral appointment.

Radiation might be the treatment of choice for frail or elderly people who do not want to undergo surgery.

In 2018, radiation oncologist Hasan Danish, MD, with the Cancer Institute, treated a 96-year-old person with a basal cell carcinoma on her forehead that hadn’t responded to chemotherapy. The individual received 20 consecutive daily treatments and healed completely with excellent cosmetic and oncologic results.

Dennis Sopka, MD, radiation oncologist and Chief, Division of Radiation Oncology, Lehigh Valley Health Network, successfully treated a person with an 8-centimeter tumor on his forehead. After five weeks of treatment, the lesion was gone.

“We want to get the word out to patients and primary care physicians that radiation therapy never went away and has improved,” Quinlan-Davidson says. “It is a highly effective treatment for many patients with nonmelanoma skin cancers, as well as an adjuvant treatment for melanoma.”