Brachytherapy – The New Era of Radiotherapy


Doctors need a broad set of tools to fight skin cancer:

Doctors diagnose skin cancer more than any other type. Over the last decade, scientist have developed innovative and less intrusive procedures. With skin cancer procedures growing at an estimated rate of 4-6 percent a year, doctors need as many tools in our toolkit as possible to treat out patients.

There are many treatment types for non-melanoma skin cancer. Most are effective, and lead to low recurrence rates. Patients need therapies that can treat the cancer, but also keep their appearance afterwards.  Doctors can treat patients with everything from surgery, to MOH’s to destructive therapies with good results, so why use brachytherapy? 

Patient and Doctor Concerns:

Patients look at brachytherapy with suspicion and doctors underutilize it for a number of reasons.  Doctors and patients typically prefer to just “cut out” the tumor, because it is simple and straightforward.   Also, it can be cumbersome for patients getting traditional radiotherapy because treatments can occur in 15-30 sessions.

Radiation therapy is also unpopular simply because of patient’s perceptions of “radioactive” elements to it.  As doctor Patel noted about traditional radiotherapies “collateral damage to healthy tissues can lead to secondary cancers and acute side effects.”  Doctors are rightfully concerned about poor local control with old fashioned techniques. 

Dr Patel continues about traditional radiotherapies. “superficial radiotherapy in its traditional form is old fashioned.” As a result “the procedures aren’t conformal, meaning it isn’t pinpoint or targeted, thus not minimizing exposure to collateral tissue.”

Why Doctors Should Consider:

Dr. Patel emphasizes the growth of Brachytherapy technologies.  Before, doctors targeted cancer with radiation pellets.  Now, doctors can create specific radiation with regular electric power.  “The game changer for this technology was that you could actually do it in a patient room, rather than being in a big bunker.” says Dr. Patel.  “So all of the sudden you can take the radiation to the patient, rather than a patient coming to a centralized system.”

With brachytherapy moving to an electrical basis, doctors can now control applications more effectively.  Patients can receive radiation and different radial depths, giving a much more precise treatment than previous radiotherapies.

There are many reasons that a patient and doctor might choose this therapy.  In terms of using it in a dermatology office, it offers a alternative around difficult anatomic sites.  Cancer cells around cartilage, the nose, head, eye or ear can be targeted for a better cosmetic outcome.  As a result, there will be less scarring, with more form and function after the treatment.

Another reason doctors can use this therapy is time.  Patients can receive more targeted and intense radiation fewer times, and still get great results.  Some older methods required up to 30 treatments, but brachytherapy can attain similar results with much fewer treatment dates.

DiseaseJonathan McClung