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Published on July 10, 2017

Unsightly skin cancer gone for goodUnsightly skin cancer gone for good

Mary Morrissey of Falmouth would be the first to tell you that she used to be afraid of doctors. But, after she saw the results of having superficial radiation therapy treatments that removed the squamous cell tumors on her face, she changed her mind.

“I used to be scared to death of what could happen and I was so negative,” said Morrissey.

The tumors began to develop about four years ago on both sides of her nose, on the left temple close to her eye, upper right cheek and lips. The tumors were originally removed surgically, but returned.

James O’Connor, MD, Morrissey’s primary care physician, recommended that she see Basia McAnaw, MD, a radiation oncologist at Falmouth and Cape Cod hospitals. After an examination and discussion of a plan with Dr. McAnaw, Morrissey decided to go ahead with the radiation treatments.

Another of her fears was that the radiation treatment would “send the cancer somewhere else.” but Dr. McAnaw was able to allay her concerns.

“Squamous cell and basal cell skin cancers are not life-threatening and they do not spread throughout the body; they do not metastasize,” said Dr. McAnaw. “They usually occur on the areas of the skin that are exposed to the sun; namely the face, the neck, arms and legs.”

About 5.4 million basal and squamous cell cancers are diagnosed every year in about 3.3 million people (some have more than one cancer) according to the American Cancer Society.

Dr. McAnaw performed three separate radiation treatments on Morrissey over a period of 18 months. Her last treatment was about two years ago and she was astounded at how well the treatments went and the eventual changes that eliminated the tumors.

“I was amazed how it came out. No scarring,” said Morrissey.

The results were “dramatic,” according to Dr. McAnaw.

How Superficial Radiation Works

“Skin cancers are very close to the surface of the skin, only about one millimeter deep,” explained Dr. McAnaw. “When we use radiation to eradicate skin cancers, (also known as lesions) we can use very shallow, penetrating radiation that doesn’t go very deep into the body.

“Small lesions can be treated quickly, within five days, large lesions may take up to 30 days.”

The patient lies on a table and a radiation therapy machine (SRT) is positioned to give an exact, predetermined dose of radiation to the tumor. The radiation is delivered through a Lucite cone placed against the lesion on the skin.

Once the patient is in position, the radiation treatment takes about two minutes.

What Happens?

Cancer cells divide more rapidly than normal cells, which proves helpful when using radiation to treat it.

“When I treat a patient with skin cancer, the cancer cells are going to die off more readily than the normal cells,” said Dr. McAnaw.

Once the cancer cells are treated with radiation, “the body’s natural defenses then come in and destroy the dying cancer cells and break them up into small packages of chemicals,” said Dr. McAnaw. “These are released and the body’s own defense creates serum (yellow liquid in a wound) that coagulates into a scab.”

“As the scab dries up and falls off the skin beneath it heals very nicely and comes to the surface,” she added. “The skin is perfectly pink and normal. It’s a miracle.”

The process of developing the scab and healing will vary according to the number of treatments. When a patient is treated for three weeks, there will be no obvious changes in the first two weeks. During the third week, the skin starts to get irritated, moist, some oozing and possible mild bleeding and then the scab forms, said Dr. McAnaw. It’s the same type of scab as one from an abrasion.

The vast majority of patients have a complete response, meaning the cancer cells go away and they do not come back, according to Dr. McAnaw.

“People have the potential for wonderful results and cosmetically superior results when they use radiation,” she said.

As for Morrissey, after the treatment she was able to return to her life confidently knowing she looked great.

“I was very pleased with Dr. McAnaw and mesmerized by the way it all came out,” she said.

Patients who are interested in learning more about radiation treatment for skin lesions can be referred to Dr. McAnaw by their primary care physicians, specialists, or they can self-refer. A biopsy for diagnosis of the basal cell or squamous cell cancers is required prior to referral.