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Published on April 04, 2019

A non-surgical way to remove skin lesions

For many skin cancer patients, surgery or cryosurgery (freezing the lesion) is the preferred treatment. But some lesions, including many of those on the face, need a different solution – and that’s where superficial radiation comes in.

Superficial in this case doesn’t mean “slight” or “minor,” but “surface.” Compared to the radiation machines used to treat cancers within the body, superficial radiation machines use a lower level of energy. They deliver a smaller dose of radiation and avoid damaging tissue beneath the skin.

“The bottom line with skin cancers is probably 95 percent of them are taken care of by the dermatologists or the surgeons,” said Daniel Canaday, MD.

“Radiation tends to play a role when things get complicated, like if someone has a very big lesion or if it’s in a very difficult location, such as around the eye or the nose or the mouth, where traditional surgery might be very deforming. We also sometimes see patients for treatment after surgery if their dermatologist believes there may be a higher than normal chance of recurrence.”

“We have a very close relationship with our dermatology colleagues in Hyannis and in Falmouth. They’re very good at getting us involved if something gets to that level of complexity.”

Board-certified in radiation oncology, Dr. Canaday works at both Cape Cod Healthcare cancer centers, the Clark Cancer Center at Falmouth Hospital and the Davenport-Mugar Cancer Center at Cape Cod Hospital.

Most of the lesions he treats are squamous cell and basal cell, he said. Superficial radiation also is used on some melanomas (along with surgery) because of the risk of recurrence.

Two High-Energy Machines

During a tour of the radiation unit at Davenport-Mugar, Dr. Canaday described the equipment used for treating different types of cancer.

Two high-energy machines are used to treat the majority of cancers.

“They produce very high energy that can penetrate deeply into the body, so that we can treat brain tumors or lung tumors,” he said.

Those machines would be overkill for skin cancer, he said, because you’re trying to treat something that’s right on the surface.

The superficial radiation machine (used in both Hyannis and Falmouth) “looks like the X-ray machine in your dentist’s office,” he said. “It produces a very low energy that barely goes under the skin surface. It’s a totally painless treatment.”

A typical treatment of superficial radiation, which is FDA approved, lasts two or three minutes, and patients come in daily for two or three weeks.

“Besides tumors in difficult locations, this is sometimes preferable for patients who are elderly or just not capable of going through surgical treatment. This is something almost anybody can do. They just have to be able to come in and put in the time on a daily basis," said Dr. Canaday.

“The main side effect is you get some skin irritation, but it doesn’t go anywhere else in the body. It doesn’t make people sick. People can be in very poor condition overall and still do this treatment.”

Dr. Canaday often speaks to the public about skin cancer.

“The key is catching them early,” he said. “We have a lot of effective means of dealing with them, but the sooner it’s dealt with, the easier it is to take care of and the less treatment people have to go through," he said.

“People who are at risk for this should be seeing their dermatologist once a year where they do something called skin mapping. They take photographs of the whole body, and if there’s a new mole or if there’s something that’s popped up in the last year, they can biopsy that.

"Skin cancer is the most common cancer in America, but fortunately it’s one of the most curable things we see. We’d rather keep it that way, so if people have a doubt, it’s better to go your doctor and have it checked out. We can deal with it effectively after that.”