Basal cell carcinoma (BCC) is a common type of skin cancer that originates in the basal cells, which are found in the outermost layer of the skin. It typically grows slowly and rarely spreads to other parts of the body, making it highly treatable. While surgery is often the primary treatment, radiation therapy offers a non-surgical alternative for specific cases, especially when surgery might be challenging or undesirable. This approach uses targeted energy to destroy cancer cells while aiming to preserve surrounding healthy tissue.
Determining the Number of Treatments
The total number of radiation treatments for basal cell carcinoma varies significantly, customized for each patient’s unique situation. Treatment schedules can range from a few sessions over one to three weeks to daily treatments five days a week for several weeks, potentially totaling 20 to 30 sessions. Factors influencing this duration include the tumor’s characteristics and the patient’s overall health.
Tumor characteristics, such as size, location, and depth, play a significant role in determining the treatment course. Larger or more deeply invasive tumors, or those located in sensitive or complex areas like the eyelids, nose, or ears, may require more extended treatment plans. The specific histological subtype of the BCC, whether superficial, nodular, or more aggressive forms like infiltrative or sclerosing, also guides the treatment intensity.
Patient-specific factors also influence the treatment schedule. Older individuals or those with other medical conditions that make surgery risky or impractical may benefit from radiation therapy, often with tailored, sometimes shorter, regimens. Previous treatments in the affected area or cosmetic considerations also factor into the decision for the optimal number of sessions. Radiation oncologists balance these elements to design a plan to eradicate cancer effectively while minimizing side effects.
Types of Radiation Therapy Used
Radiation therapy for basal cell carcinoma primarily involves two main delivery methods: external beam radiation therapy and brachytherapy. Each method is chosen based on the tumor’s characteristics and its location, influencing the overall treatment schedule.
Superficial Radiation Therapy (SRT) is an external beam method that uses low-energy X-rays, making it suitable for lesions located on the skin’s surface. This approach delivers radiation to the outer skin layers, often with a typical schedule of one to three sessions per week. The number of fractions for SRT can range from 15 to 30.
Electron beam radiation is another external technique used for skin cancers, particularly when the tumor is deeper but still close to the surface, allowing for sparing of underlying tissues. This method employs higher-energy electrons to penetrate to a controlled depth. Electron beam therapy schedules can vary, with some regimens involving as few as five fractions, while others extend to 10 or 18 fractions.
Brachytherapy involves placing a radioactive source directly on or within the tumor, delivering a high dose of radiation to a localized area while minimizing exposure to surrounding healthy tissues. This method often requires fewer, higher-dose sessions over a shorter period compared to external beam therapies. Brachytherapy schedules involve six to eight fractions and are advantageous for tumors in sensitive or anatomically complex regions, such as the face.
The Patient Experience During Treatment
Radiation therapy begins with a planning phase, known as simulation. During this initial appointment, medical imaging, often including CT scans or ultrasound, is used to map the tumor’s location and dimensions. Marks may be placed on the skin to ensure accurate positioning for each session.
Daily radiation sessions are brief, lasting only a few minutes for radiation delivery. The entire process, including patient positioning, might take 10 to 20 minutes. Patients lie on a treatment table, and the procedure is painless and non-invasive. The frequency of these sessions is often five days a week, over several weeks, though some schedules may involve fewer weekly visits.
During treatment, patients have regular check-ins with their radiation therapists and nurses. They discuss any emerging side effects or concerns. Monitoring ensures patient comfort and treatment progress.
After Radiation Treatment: What to Know
After radiation therapy, patients recover as the treated skin heals. Common and temporary skin reactions include redness, dryness, and peeling, similar to a sunburn, which are localized to the treated site. These reactions usually appear one to two weeks into treatment and can persist for weeks or months after the final session.
Managing skin changes is important. Providers recommend creams or emollients to soothe skin and promote healing. Protecting the treated area from sun exposure is important during this time and long term.
Regular follow-up appointments with a dermatologist or radiation oncologist are important after completing radiation therapy. These visits monitor the treated area for healing and signs of recurrence or new lesions. Recurrence in the treated area is uncommon, and re-treating the same area with radiation is generally not advised due to increased side effects. Long-term skin changes, such as altered pigmentation or texture, can occur, and hair loss in the treated region may be permanent.