HDR Brachytherapy Eases Skin Cancer Treatment

Former Cancer Patient

Faced with early-stage prostate cancer, Randy Jensen dug in and researched his treatment options. The farmer from Blair, Nebraska, ultimately chose high-dose rate brachytherapy at CHI Health Creighton University Medical Center – Bergan Mercy. This internal radiation treatment minimizes damage to surrounding organs and only required two outpatient visits compared to 40 or more treatments of external beam treatment. While Jensen’s PSA had spiked at 9 ng/ml in February 2016, shortly after treatment he was back on his tractor and three months later his PSA was down to 2.5 ng/ml.

Patients facing non-melanoma skin cancer can now receive a new proven technology to treat cancer precisely and without surgery at CHI Health St. Elizabeth.

High-dose rate (HDR) brachytherapy delivers radiation directly to the cancerous lesion using a specially designed applicator. It eliminates the potential visible scarring left by surgery, which has traditionally been the most common skin cancer treatment.

Kevin Yiee, MD, medical director of St. Elizabeth Radiation Therapy Center, said the treatment uses an Iridium-192 radioactive pellet that sits right on top of the cancerous skin.

“It sits on top of the lesion for a couple of minutes, allowing radiation to be absorbed into the skin lesion, and kills the cancer just as effectively as surgery, meaning that 90 to 95 percent of the time after this treatment, the cancer will not return,” Dr. Yiee said. “Oftentimes, especially in older patients, they have more than one spot that needs to be treated. With this, we can treat all cancerous spots in one treatment. They don’t have to go through multiple courses.”

When Nancy Gondringer learned she had basal-cell carcinoma, she assumed she would have to undergo major nose surgery.

“My aunt had a spot on the bridge of her nose. To remove it, she underwent significant nasal surgery,” Gondringer said. “It took much longer to heal and was more invasive than brachytherapy.

“I know brachytherapy was the right treatment for me. Dr. Yiee removed the cancer without any scarring.”

The treatment is delivered on an outpatient basis in six or 10 sessions that last about 10 minutes, allowing patients to resume normal activities the same day. The success rate is the same as traditional surgery and patients are typically more pleased with the outcome.

“The only limitation is that we typically use this procedure for cancer that only penetrates the skin less than half of a centimeter,” Dr. Yiee said. “After treatment, patients will have redness at the application area comparable to a sunburn, but by a month afterward, things get better. Two months afterward, sometimes it’s difficult to tell people have even had treatment.”

Skin cancer is common, but most cases are highly curable. “With HDR brachytherapy, we see cure rates equal to surgery and patients are pleased with the cosmetic outcome,” Dr. Yiee said.

Kevin C. Yiee, MD

Radiation Oncology