Have You or a Loved One Been Diagnosed with Nonmelanoma Skin Cancer and Need Advanced Treatment?

If so, you are not alone. Millions of people are diagnosed with some type of nonmelanoma skin cancer each year. The most common types are basal cell carcinoma and squamous cell carcinoma. The good news is that these types of skin cancers are often very treatable, and there are many ways to treat them.

One way to treat skin cancer is through a traditional surgical approach. Our practice offers traditional surgical treatments, including excision or electrodesiccation and curettage, which may be performed by one of our Dermatology or Plastic Surgery providers. 

For some patients, a non-surgical approach may be more appropriate. Our providers may recommend IG-SRT, or image-guided superficial radiotherapy, which is a non-surgical treatment that uses low levels of X-ray energy to kill the cancer cells and allow normal tissue to grow back in its place.

What You Should Know About IG-SRT

What is IG-SRT?

IG-SRT, or image-guided superficial radiotherapy, is a non-surgical treatment that uses low levels of X-ray energy to kill the cancer cells and allow normal tissue to grow back in its place. IG-SRT can be performed in the doctor’s office.

What to expect with IG-SRT

With IG-SRT, you will sit in a chair, and a gel will be applied to the body at the site of the cancer. The doctor will hold a small imaging wand over the site, and a detailed image of the cancer will appear on screen. The doctor will use that image to measure the size and shape of the tumor, calculate the dose of treatment, and define the treatment area. Once complete, the arm of the device will be placed over the treatment site, and the exact dose of X-ray energy will be used to precisely target the cancer site without harming the normal tissue around it. IG-SRT is the only skin cancer treatment with ultrasound imaging, so you and your doctor can see the cancer, precisely target the tumor, and watch it shrink over the course of treatment. IG-SRT is delivered in stages, which typically involve 3 to 5 treatments per week for 4 to 7 weeks. Each treatment is painless and can be done in as little as 15 minutes. Up to 3 tumors can be treated at one time, and the dose can be adjusted at every stage based on tumor response.

Is IG-SRT effective?

IG-SRT has a cure rate of 99% for basal cell carcinoma and squamous cell carcinoma, making it one of the most effective treatments available for advanced skin cancer based on the clinical studies.

What to expect after treatment:

When X-ray energy is used to kill cancer cells, dead cancer cells are replaced by healthy tissue over time, so there is no scarring. There is a small risk of skin atrophy (thinning of the skin) and pigment changes (changes in the color of the skin) at the treatment site, but the chances of that are low.

What are the possible side effects?

Side effects may include skin inflammation with redness and swelling at the treatment site. These side effects often go away 2 to 6 weeks after treatment is complete. Topical creams or ointments may be used throughout the course of treatment to help minimize the side effects. There is less than a 5% chance of developing a secondary cancer 20 to 40 years after treatment. There is also a risk of alopecia (hair loss) in the area of the body that has been treated.

Who Might Benefit From IG-SRT?

IG-SRT is an option for people who:

  • Would prefer a nonsurgical treatment
  • May not be candidates for surgery
  • Want to see the cancer shrink, so they know the treatment is working
  • Have multiple lesions that need to be treated
  • Want to avoid the potential side effects of surgery (cutting, bleeding, scarring)

Care about cosmetic results

Unlike Mohs surgery, there is no cutting, bleeding, scarring, or need for reconstructive surgery. You will not require anesthesia. You can continue with your normal daily activities during the course of treatment.

Is IG-SRT covered by my insurance?

IG-SRT is covered by most commercial insurances and Medicare. With most insurance plans, you may have to pay some out-of-pocket cost based on your specific coverage plan and deductibles. 

The amount can range from very little out-of-pocket expense to a few thousand dollars. Your doctor’s office can work with your insurance plan to determine your cost. While other radiotherapies exist, IG-SRT is the only one with ultrasound imaging that lets you and your doctor see the cancer inside the body while it is being treated. 

What You Should Know About Systemic Therapies

Three main types of systemic therapy:

Targeted therapy: Blocks the growth and spread of cancer cells while limiting damage to healthy cells.

Chemotherapy: Stops the cancer cells from growing, dividing, and making more cells.

Immunotherapy: Boosts the body’s natural defenses to fight cancer.

What are systemic therapies?

Systemic therapies are prescription medications that are given through the bloodstream to destroy cancer cells in the body. Some systemic therapies can be taken at home. Others must be administered in a healthcare setting.

How do systemic therapies work?

Systemic therapies can be delivered through an intravenous (IV) tube that is placed into the vein through a needle, a gel or cream that is rubbed onto the skin, or a pill or capsule that is swallowed.

What to expect from systemic therapies:

Depending on the type and severity of the cancer, you may be given one or a mix of systemic therapies. Depending on the skin cancer, these therapies may need to be taken for several weeks, months, or years. Should your doctor recommend systemic therapy, they will help you better understand what to expect with the chosen course of treatment.

Are systemic therapies effective?

Systemic therapies have cure rates ranging from 61% to 84%. Effectiveness depends on the type of prescription medicine used, the stage of the cancer, and how well you adhere to the care plan.

What are the possible side effects?

The side effects depend on the medication being used.

Chemotherapy creams can cause irritation, burning, redness, and stinging during treatment. These symptoms usually go away after treatment has stopped.

Targeted therapies may cause hair thinning, muscle cramps, weight loss, dry skin, and loss of taste.

Immunotherapies can have a range of side effects, from fatigue, rash, and diarrhea to more severe and possibly life-threatening side effects, such as lung problems, intestines, liver, hormone glands, skin, and kidneys. Be sure to discuss the side effects of any medication with your doctor before taking it.

Who might benefit from systemic therapies?

Systemic therapies are an option for people who:

  • Have advanced skin cancer and are not candidates for surgery or IG-SRT.
  • Would prefer not to have surgery or IG-SRT.
  • Are treated with surgery or IG-SRT and would benefit from additional treatment methods.

Are systemic therapies covered by my insurance?

The cost of treatment and how much will be covered by insurance depends on your plan and the type of systemic therapy your doctor recommends. Discuss this with your doctor and office staff before beginning any skin cancer treatment.

What Option Is Right for Me

Asking questions about all the available treatment options, and being open and honest with your doctor about your personal goals, is the best way to ensure you get the treatment that is right for you.

Treatment decisions should be based on two things:

  • Clinical factors
    • These are things your doctor will consider when making a treatment recommendation, such as:
      • The type of cancer cells.
      • The size and location of the tumor.
      • The effectiveness and potential side effects of each treatment option.
      • Your health profile, including other health conditions you may have and medications you may be taking.
  • Personal goals
    • These are things that are important for you to consider, such as:
      • What you want out of treatment.
      • How comfortable you are with the benefits and risks of each treatment option.
      • How well the treatment option fits into your daily lifestyle.

Questions that can help you define your personal treatment goals

  • Would you prefer a surgical or nonsurgical treatment option?
  • Do you have multiple tumors that need to be treated?
  • Is your cancer located in a visible area of the body where cosmetic results and scarring are a concern, such as around the ears, eyes, cheeks, forehead, lips, chin, scalp, or nose?
  • Would you be comfortable having surgery without knowing if you will need reconstructive surgery afterward?
  • Would you find comfort in seeing the tumor shrink while it is being treated?
  • Do you have the time and transportation needed for multiple short visits to the doctor’s office over the course of a few weeks?
  •  How important is it for you to remain active without restrictions to your daily activities during and after treatment?

Be sure to discuss your answers with your doctor so you can work together to determine what treatment may be right for you. 

Your personal goals are just as important as the clinical factors of your cancer. Be sure to tell your doctor what you want out of treatment and what treatment option you think is right for you.


The Golla Center for Dermatology in Pittsburgh is ready to help! Contact us today for a risk free exam and consultation.

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